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centration ≤ 37.5 ng/ml. Sixty-four patients received either weekly vitamin
D3(n=31) or placebo (n=33) for 6 months; both groups received
800 mg calcium citrate daily. Baseline and 6 month measures
included peak VO2, 6 minute walk distance (6MW) and Get Up and
Go. Isokinetic muscle strength was measured at 60 and 120 degrees
using knee extensors and flexors. Health status was measured with
the Kansas City Cardiomyopathy Questionnaire (KCCQ). Between
group comparisons were made using ANCOVA models that adjust
for baseline measures.
Results: Subjects in the vitamin D group were 65.8 ± 10.6 years
old, 52% women, and 61% African American. Subjects in the placebo
group were 66.0 ± 10.4 years old, 46% women and 67% African
American. At baseline the vitamin D group mean serum 25OHD was
19.1 ± 9.3ng/ml and increased by 42.3 ± 16.4 ng/ml at 6 months. Baseline
mean serum vitamin D in the placebo group was 17.8 ± 9.0 ng/ml,
and decreased by 0.2 ± 6.6 ng/ml at 6 months (between groups
p0.15). Adjustment for baseline characteristics sex,
race, and ejection fraction did not change results.
Conclusions: There is no evidence to suggest that high dose vitamin
D3 improves physical performance or health status for older
adults with HF. Vitamin D repletion in patients with HF should conform
to standard vitamin D guidelines for older adults.
P23
Improving 25-hydroxyvitamin D Status in Home-bound Elders and
its Effect on Falls.
D. K. Houston, 1 J. A. Tooze, 1 J. L. Demons, 1 B. Davis, 1 R. Shertzer-
Skinner, 1 L. Kearsley, 2 R. Gottlieb, 2 J. D. Williamson. 1 1. Sticht Center
on Aging, Wake Forest School of Medicine, Winston Salem, NC; 2.
Senior Services, Inc., Winston Salem, NC.
Supported By: Supported by the Wake Forest Translational
Science Institute, Center for Integrative Medicine and Pepper
Center (P30-AG21332).
Background: Home-bound older adults are a particularly vulnerable
subgroup of older adults for poor dietary intake and nutritional
health, nutrition-related health conditions, and functional decline.
Although vitamin D supplementation has been shown to be
effective in preventing falls in controlled clinical trials, whether these
findings can be successfully translated to community-based programs
has not yet been determined. We conducted a 5-month randomized,
placebo-controlled pilot study to assess the feasibility of delivering vitamin
D supplements to home-bound older adults receiving Meals on
Wheels (MOW) and the effectiveness of the vitamin D supplements
to improve 25-hydroxyvitamin D (25(OH)D) levels and reduce falls.
Methods: Sixty-eight MOW clients in Forsyth Co, NC, who were
not currently taking prescription vitamin D 2
or >1000 IU/day of vitamin
D 3
were enrolled from December 2010 through March 2011
(mean age, 77.8 yrs; 72% women; 75% black). Serum 25(OH)D was
measured at baseline and 5-month follow-up and falls assessed by
monthly fall calendars and phone calls. Participants were randomized
by MOW route to receive 100,000 IU vitamin D 3
(n=38) or an active
placebo control (n=30) once a month along with their MOW meal.
Results: Serum 25(OH)D levels (mean±SD) at baseline were
22.5±12.2 and 18.9±10.6 ng/mL in the intervention and control group,
respectively (p=0.22). Ninety percent of participants received 4 or
more of the 5 vitamin D/placebo monthly doses. Serum 25(OH)D
levels improved significantly in the intervention group compared to
the control group (LS means±SE: +20.4±1.8 vs. -2.2±2.1 ng/mL adjusted
for age, gender, race, randomization group and baseline
25(OH)D, p1.0 m/s and impaired
motor skill (by Figure of 8 walk time, F8WT > 8 secs).
Methods: Forty older adults were randomized to MS or SE
treatment arms. Both arms were 1 hour, twice weekly, PT-supervised
interventions for 12 weeks. Pre and post intervention assessments
performed by masked assessors included gait efficiency or energy
cost of walking (mean rate of O2 consumption for 3 minutes of preferred
speed treadmill walking divided by speed, ml/kg-m), gait
speed, obstacle walk, F8WT and the Late Life Function and Disability
Index disability subscale (LLFDI). Outcomes between arms were
compared with ANCOVA, adjusted for the pre-intervention value.
Results: Of 40 randomized subjects; 38 completed the trial (MS,
n=18; SE, n=20; mean age 77.1±6.0 years). Gait efficiency improved
(energy cost decreased) marginally more in MS than SE (- 0.04 vs. -
0.02 ml/kg-m, adjusted difference, AD=0.03, p=0.13). MS improved
more than SE in gait speed (0.13 vs. 0.05 m/s; AD=0.11, p=0.008); obstacle
walk time (-0.89 vs. -0 .42 secs; AD=0.60, p=0.01), and F8WT (-
0. 22 vs. -0.89 seconds; AD=1.39, p