Mortensen Charlotte, Beck Anne Marie, Tetens Inge, Jeppesen Charlotte, Jørgensen Søren Frank, Nielsen Leif Kofoed, Kristensen Michael
Department of Nursing and Nutrition Faculty of Health University College Copenhagen, Copenhagen, Denmark.
Dietetic and Nutritional Research Unit Herlev Gentofte Hospital, Hellerup, Denmark.
J Nutr Metab. 2024 Oct 5;2024:2405429. doi: 10.1155/2024/2405429. eCollection 2024.
Dietary supplements with vitamin and calcium are recommended to nursing home residents in Denmark, but adherence to the recommendation is low. In a previous part of this study, we reported improved adherence by means of The Model for Improvement leading to increased awareness and change of workflows at two nursing homes. However, potential effects of this improved adherence are unknown.
The objective of this substudy was to investigate if the improved adherence to the recommendation affected vitamin D status, muscle strength, and physical functioning of the residents.
This was a 20-week quasiexperimental study involving 40 residents from two Danish nursing homes. Baseline and endpoint measurements took place in October 2021 and March 2022, respectively. Outcomes were number of residents taking vitamin D and calcium supplements; vitamin D status; handgrip strength; and physical functioning with timed-up-and-go test and 30-second chair stand test.
Prevalence of vitamin D supplement users increased from 45 to 78% (mean dose 41 g) and of calcium supplement users from 40 to 72% (mean dose 769 mg) (both =0.002). Among those having blood sampled at both baseline and endpoint ( = 30), mean vitamin D status increased from 66.6 ± 31.7 nmol/L to 82.8 ± 26.3 nmol/L ( < 0.001), and more residents were vitamin D sufficient at endpoint (90 vs. 63%, =0.021). Endpoint vitamin D status among supplement users was 88.2 ± 22.2 nmol/L, which was higher compared to nonsupplement users (55.3 ± 30.4 nmol/L, < 0.01). No effects were seen on muscle strength or physical functioning.
Increased supplementation with vitamin D using The Model for Improvement positively affected vitamin D status and prevalence of vitamin D sufficiency but did not affect muscle strength or physical functioning. Longer-term studies involving more residents are needed to investigate effects of improved adherence on these outcomes. This trial is registered with NCT04956705.
丹麦建议养老院居民服用含维生素和钙的膳食补充剂，但对该建议的依从性较低。在本研究的前一部分，我们报告了通过改进模式提高了依从性，从而提高了两家养老院居民的认知度并改变了工作流程。然而，这种依从性提高的潜在影响尚不清楚。
本子研究的目的是调查对建议依从性的提高是否会影响居民的维生素D状态、肌肉力量和身体机能。
这是一项为期20周的半实验性研究，涉及来自两家丹麦养老院的40名居民。基线测量和终点测量分别于2021年10月和2022年3月进行。结果指标包括服用维生素D和钙补充剂的居民人数；维生素D状态；握力；以及通过计时起立行走测试和30秒坐立测试评估的身体机能。
维生素D补充剂使用者的比例从45%增加到78%（平均剂量41微克），钙补充剂使用者的比例从40%增加到72%（平均剂量769毫克）（两者均P=0.002）。在基线和终点均进行血液采样的人群中（n=30），平均维生素D状态从66.6±31.7纳摩尔/升增加到82.8±26.3纳摩尔/升（P<0.001），并且在终点时维生素D充足的居民更多（90%对63%，P=0.021）。补充剂使用者的终点维生素D状态为88.2±22.2纳摩尔/升，高于未使用者（55.3±30.4纳摩尔/升，P<0.01）。未观察到对肌肉力量或身体机能的影响。
使用改进模式增加维生素D补充剂的摄入量对维生素D状态和维生素D充足率有积极影响，但对肌肉力量或身体机能没有影响。需要开展涉及更多居民的长期研究来调查依从性提高对这些结果的影响。本试验已在ClinicalTrials.gov注册，注册号为NCT04956705。
