Vitamin D and secondary hyperparathyroidism in the institutionalized elderly: a literature review.

Low vitamin D status is recognized as a prevalent disorder in certain high-risk groups. The greatest prevalence has been reported in the institutionalized elderly. The goal of this article is to review the literature pertaining to vitamin D deficiency in the institutionalized elderly and to highlight the need for treatment in this high-risk group. A computer search for English language articles from 1980 to February 2007 was conducted using the PubMed database and key words vitamin D, hyperparathyroidism, elderly, institutionalization, and nursing home. Several risk factors have been noted, which are more prominent in the institutionalized elderly, including decreased sun exposure, poor oral intake, and multiple comorbidities. Long-term care residents should be prescribed higher doses of calcium and vitamin D for adequate bone mineral density and fracture prevention.