Effects of High Dose Intramuscular Cholecalciferol and Oral Cholecalciferol on Vitamin D Levels and Physical Performance in Elderly

Objective: To evaluate the effects of high dose intramuscular cholecalciferol and oral cholecalciferol on vitamin D levels, muscle strength and physical performance in elderly patients with vitamin D deficiency or insufficiency.Material and Method: 116 ambulatory individuals aged 65 years and older living in a nursing home were evaluated. Demographic and descriptive data of 66 patients who fulfilled the inclusion criteria were investigated. Serum 25(OH)D levels lower than 10 ng/ml are accepted as deficiency, whereas between 10-29 ng/ml as insufficiency. Individuals with Vitamin D deficiency/insufficiency were randomized into IM and Oral groups according to administrating technique of 600.000 IU cholecalciferol. Follow-up of the patients was performed at 6 and 12 weeks after cholecalciferol treatment. Biochemical evaluations were done at the beginning, 6th and 12th weeks. Quadriceps muscle strength measurement by MicroFET3 manual muscle tester and physical performance evaluation by Short Physical Performance Battery (SPPB) were done at the beginning and 12th week.Results: Deficiency and insufficiency were detected in % 37.1 (n=43) and % 57.8 (n=67) of the individuals (n=116), respectively. Vitamin D levels were sufficient in only % 5.2 (n=6). Deficiency and insufficiency were detected in % 42.4 (n=28) and % 57.6 (n=38) of the patients included in the study (n=66), respectively. Significant increase in vitamin D levels was determined in both groups at 6 and 12 weeks after cholecalciferol treatment. However the increase in the IM group was significantly higher than the Oral group at 12th week (p=0.003). Significant improvement was detected also in quadriceps muscle strength and physical performance scores at 12 weeks. However no correlations were detected between quadriceps muscle strength, physical performance tests and Vitamin D levels.Conclusion: Vitamin D deficiency is common among the elderly population, especially living in nursing homes. Elderly people should be evaluated primarily in order to maintain the optimal levels, as Vitamin D plays an essential role in neuromuscular functions. Concerning low compliance to daily treatment, especially in elderly, periodic application of high dose vitamin D is a safe and effective treatment option.Key words: Vitamin D, elderly, muscle strength, physical performance