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Calcium and vitamin D status were studied in 193 healthy elderly French people. Calcium intake was < 500 mg/d in 62% of the patients and the vitamin D intake was < 5 µg/d in all patients. They also exhibited reduced levels of serum calcium (SCa) and 25-hydroxyvitarnin D (25-OHD) and high levels of parathyroid hormone (PTH) and alkaline phosphatase(SAP). The response to calcium (1000 mg/d)and ergocalciferol (20 μg/d) given for 6 mo was evaluated in 65 patients with 69 subjects taken as controls. The treatment induced a significant increase in SCa and in 25-OHD levels, and a subsequent decrease in PTH levels without modification of the mean calcitriol levels. The biochemical changes were more marked in long-stay hospital patients than in outpatients. All these changes were significantly different from those observed in the control group. Increasing the calcium and vitamin D intake reduces the biochemical signs of secondary hyperparathyroidism in elderly people. [ABSTRACT FROM AUTHOR]

Objective: To assess the cost implications for a preventive treatment strategy for institutionalised elderly women with a combined 1200 mg/day calcium and 800 IU/day vitamin D3 supplementation in seven European countries. Design: Retrospective cost effectiveness analysis based on a prospective placebo-controlled randomised clinical trial. Data sources: Recently published cost studies in seven European countries. Clinical results from Decalyos, a 3-year placebo-controlled study in elderly institutionalised women. Trials: Decalyos study, with 36 months follow-up of 3270 mobile elderly women living in 180 nursing homes, allocated to two groups. One group received 1200 mg/day elemental calcium in the form of tricalcium phosphate together with 800 IU/day (20 μg) of cholecalciferol (vitamin D3), the other placebo. Results: In the 36 months analysis of the Decalyos study, 138 hip fractures occurred in the group of 1176 women, receiving supplementation and 184 hip fractures in the placebo group of 1127 women. The mean duration of treatment was 625.4 days. Adjusted to 1000 women, 46 hip fractures were avoided by the calcium and vitamin D3 supplementation. For all countries, the total costs in the placebo group were higher than in the group receiving supplementation, resulting in a net benefit of €79 000–711 000 per 1000 women. Conclusion: This analysis suggests that the supplementation strategy is cost saving. The results may underestimate the net benefits, as this treatment has also shown to be effective in decreasing the incidence of other non-vertebral fractures in elderly institutionalised women. [Copyright &y& Elsevier]