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Underutilization of Calcium and Vitamin D by Older Adults in a Large General Internal Medicine Practice

Ness, Jose1*; Aronow, Wilbert S2; Newkirk, Erin1; McDanel, Deanna1

American Journal of Therapeutics: March-April 2005 - Volume 12 - Issue 2 - p 113-116
doi: 10.1097/01.mjt.0000132254.88027.71
Original Articles

The underutilization of calcium and vitamin D supplements in the prevention and treatment of osteoporosis is common among high-risk elders. Less is known about the prevalence and adequacy of calcium and vitamin D use by the general population of older adults. We performed a retrospective chart analysis of 617 women and 383 men over the age of 60 (mean age 73 ± 9 years) seen at an internal medicine practice to establish the prevalence and evaluate the adequacy of calcium and vitamin D supplementation. Adequate supplementation was defined according to the National Osteoporosis Foundation guidelines and the National Institutes of Health Consensus Development Panel on Osteoporosis. Osteoporosis or osteopenia was documented in 207 (33.6%) women and 21 (5.5%) men (P < 0.01). Of 383 men, 116 (30.3%) used calcium, 25 (6.5%) used adequate doses of calcium, 109 (28.5%) used vitamin D, and only 8 (2.1%) used adequate doses of vitamin D. Of 617 women, 415 (67.3%) used calcium, 199 (32.3%) used adequate doses of calcium, 347 (56.2%) used vitamin D, and 83 (21.7%) used adequate doses of vitamin D. When compared with women, men were less likely to be on calcium (OR 0.21, 95% CI 0.16-0.28), on adequate calcium replacement (OR0.15, 95% CI 0.11-0.23), on vitamin D (OR 0.32, 95% CI 0.25-0.42), and on adequate vitamin D replacement (OR 0.13, 95% CI 0.07-0.26). Calcium and vitamin D were greatly underutilized among older patients in an internal medicine clinic. Inadequate replacement doses were common, and men were particularly susceptible to undertreatment.

1Department of Internal Medicine, University of Iowa School of Medicine, Iowa City, Iowa; and the 2Department of Medicine, Division of Geriatrics, New York Medical College, Valhalla, New York.

*Address for correspondence: Department of Internal Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242. E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.