From the Guidelines
Vitamins and minerals are indicated for older adults who have specific deficiencies or are at high risk for inadequate intake, with a particular emphasis on vitamin D and calcium for bone health, as well as vitamin B12 due to decreased absorption with age and certain medications 1.
Key Nutrients for Older Adults
- Vitamin D: essential for bone health, with a recommended daily intake of 10-20 μg, and supplementation is necessary to meet requirements, especially for those with limited sun exposure or dairy intake 1.
- Calcium: crucial for bone health, with a recommended daily intake of 950 mg, and supplementation may be needed for those who consume less than one portion of calcium-rich dairy foods daily 1.
- Vitamin B12: important for nerve function and red blood cell formation, with a recommended daily intake of 2.4 mcg, and supplementation may be necessary due to decreased absorption with age and certain medications 1.
- Iron: should only be supplemented if a deficiency is confirmed through blood tests, as excessive intake can be harmful 1.
Implementation and Considerations
- Older adults should discuss supplementation with their healthcare provider before starting, as excessive intake of certain vitamins can be harmful 1.
- Regular reassessment of nutritional status is important, as needs may change over time due to age-related physiological changes, medication interactions, and limited dietary variety 1.
- A daily multivitamin may be appropriate for elderly individuals, especially for those with reduced energy intake, to reduce the risk of deficiencies 1.
- Dietary recommendations should include a variety of foods, such as lean meats, dairy products, green leafy vegetables, and fortified breakfast cereals, to ensure adequate intake of essential nutrients 1.
From the Research
Indications for Vitamins and Minerals in Older Adults
- Vitamins and minerals are essential for older adults due to their higher risk of deficiency compared to younger adults 2.
- Proper vitamin nutrition can help prevent deficiencies that may masquerade as other morbidities, such as skin, neurologic, and gait abnormalities 2.
- Older adults are particularly vulnerable to deficiencies of calcium, vitamin D, and vitamin B12, despite the availability of fortified foods 3.
Recommendations for Vitamin and Mineral Supplementation
- The general recommendation is to take one multivitamin daily, with extra supplementation of individual vitamins based on specific risk factors, such as:
- Extra vitamin E for patients with cardiovascular risk factors or Alzheimer's dementia 2.
- Extra vitamin D for patients with known osteoporosis, osteoporosis risk factors, or strong risk factors for vitamin D deficiency 2.
- Extra folate for patients with cardiovascular risk factors, especially smokers, and alcoholics 2.
- Extra thiamine for alcoholics 2.
- Multivitamin/mineral (MVM) supplements can substantially increase vitamin and mineral intakes and blood concentrations, improving overall micronutrient status 3.
- However, there is limited scientific support for the health-related efficacy of MVM supplements, and recommendations should be individualized based on specific nutritional needs and health status 4.
Importance of Adequate Nutrition
- Adequate nutrition is essential for preserving bone mass and reducing the risk of osteoporosis and fractures, with vitamins such as vitamin B, C, E, and K playing a role in bone health 5.
- A high-quality, nutritionally dense diet is crucial for older adults to optimize health and well-being, with individualized guidance needed to overcome medical, physical, and social barriers to a healthy diet 6.