The ABD's of long-term care: A review of the use of some vitamin supplements in the LTC setting

Nutritional supplementation is common in the long-term care (LTC) setting. Vitamin Adeficiency is rarely seen in LTC, and there is some evidence that supplementation may be harmful to these residents. Studies support benefits of vitamin B12 and folate in individuals who have a deficiency, and the relative risk of supplementation is small. Methylmalonic acid measurements and 1-mg doses of cyanocobalamin and folic acid may be prudent for deficient LTC residents. Finally, vitamin D may help to prevent a variety of conditions from infection to falls. Vitamin D may be one of the most useful single vitamin supplements that can be provided to LTC residents. How to best supplement vitamin D is not entirely clear. Daily dosing of vitamin D or intermittent dosing with megadoses (50,000 IU capsules) are both options to consider. This article reviews supplementation with vitamins A, B, and D based on recent data on risk and benefits, especially in a frail older population.