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BioMed Research International
Volume 2013 (2013), Article ID 463589, 13 pages
http://dx.doi.org/10.1155/2013/463589
Review Article

Evidence for the Treatment of Osteoporosis with Vitamin D in Residential Care and in the Community Dwelling Elderly

1Older Persons Health Specialist Service, Canterbury District Health Board, Christchurch 8022, New Zealand
2Department of Medicine, University of Otago, Christchurch 8140, New Zealand
3North Metropolitan Area Health Service, Perth, WA, Australia
4University of Western Australia, Perth, WA, Australia
5Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia

Received 30 April 2013; Accepted 12 July 2013

Academic Editor: William B. Rodgers

Copyright © 2013 John A. A. Geddes and Charles A. Inderjeeth. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Vitamin D is common treatment for osteoporosis. Both age >70 years and living in residential care are associated with increased fracture risk. Community dwelling elderly are a heterogeneous group who may have more similatiry with residential care groups than younger community dwelling counterparts. Aims. To review the evidence for cholecalciferol or ergocalciferol tretment of osteoporosis in either community dwelling patients aged ≥70 years of age, or redidential care patients. Secondly endpoints were changes in bone mineral denisty, and in bone turnover markers. Methods. We performed a literature search using search terms for osteoporosis and vitamin D. Treatment for at least one year was required. Results. Only one residential care study using cholecalciferol, showed non-vertebral and hip fracture reduction in vitamin D deficient subjects. In the community setting one quasi randomised study using ergocalciferol showed reduction in total but not hip or non-vertebral fracture, and a second randomised study showed increased hip fracture risk. Three studies reported increases in hip bone mineral denisty. Discussion. A minority of studies demonstrated a fracture benefit form vitamin D and one suggested possible harm in a community setting. Current practice should be to only offer this treatment to subjects identified as deficient.