Too Few Elderly Patients Take Vitamin D Post Hip Fracture

A surprisingly low number of elderly hip fracture patients are consistently taking vitamin D, a supplement thought to be instrumental in preventing repeat fractures, shows a study presented at the 2017 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in San Diego this week.

"Vitamin D supplementation following hip fracture surgery is grossly under-prescribed," said Mohit Bhandari, M.D., in a news release. Dr. Bhandari is the study’s co-author and research chair of musculoskeletal trauma and surgical outcomes at McMaster University in Ontario, Canada. "Given its potential to improve patient function independent of other therapies, it seems improved advocacy and education - aimed at doctors and patients - about vitamin D supplementation is both worthwhile and evidence-based."

This was a blinded, multi-center randomized controlled trial of 573 hip fracture patients who were treated with cancellous screws or sliding hip screws. Most of the patients were female (66.3%) with a mean age of 74.1 years. Most of the patients were treated for undisplaced fractures (72.4%).

Over the course of two years, some of the patients (18.7%) reported never having taken vitamin D, 35.6% took vitamin D inconsistently, and 45.7% took vitamin D consistently. The adjusted analysis found that consistent vitamin D supplementation post-fracture was associated with an increase of 2.42 in the physical component of the 12-month SF-12 score (p=0.033). 

A study co-author, Earl Bogoch, M.D., an orthopaedic surgeon at the University of Toronto, said in a news release: "The benefits, safety and ease of taking vitamin D appear to be unknown or ignored by this representative cohort group of elderly osteoporotic patients who are identified by numerous guidelines as being most likely to benefit."

Vitamin D plays a critical role in general bone health and as such, daily supplementation is recommended. The findings “suggest a potential need for additional strategies to promote compliance with vitamin D supplementation in this population. Our research also found that vitamin D was associated with improved physical function following a hip fracture,” the authors wrote.In the U.S., an estimated 44 million people have osteoporosis and another 10 million are at risk for the disease which causes progressive bone loss and increased fracture risk. One in two women and one in four men older than age 50 years will sustain a bone fracture caused by osteoporosis.

The U.S. Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies recommends 600 International Units (IUs) of vitamin D each day for adults, and 800 IUs for Americans age 71 and older, the AAOS reported.

References:

Sheila Sprague, Gerard Slobogean, Earl R Bogoch, Brad Petrisor, Alisha Garibaldi, Nathan N O'Hara, Mohit Bhandari, FAITH Investigators. “Vitamin D Use and Health Outcomes Following Hip Fracture Surgery,” 2017 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in San Diego. March 2017.