Apr 9, 2020
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Multivitamin Use Among the Elderly

Proper nutrition at any age is important.  As one ages, eating habits may change but one thing remains consistent, nutritional needs should be obtained primarily from foods. Nutrient needs can be met through healthy eating patterns that include nutrient-dense foods which contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects.

Older adults, especially those living in long term care usually have physiological decline, multiple comorbidities and underlying health conditions, and take several medications. As a result, some of them may face undernutrition and require more energy, protein and micronutrients.  On the other hand, with taking too many drugs as well as dietary supplements, risk of duplicative use or polypharmacy as well as drug-nutrient interactions is high in this population.

A person’s micronutrient intake may be inadequate when they are restricting energy intake for weight loss/control, not consuming an adequate amount of food to meet energy requirements as a result of poor appetite or illness, eliminating one or more food groups from their diet on a regular basis, or consuming a diet low in nutrient-rich foods despite adequate or excessive energy intakes.

For many, eating habits prior to being admitted to a nursing facility may have been inadequate for a variety of reasons, including limited access to nutrient rich foods.  Regulatory requirements state the nursing home must provide each resident with a nourishing, palatable, and well-balanced diet that meets dietary requirements and any special dietary needs.  Therefore, those with adequate intakes at meals are most likely meeting their daily nutrient requirements through food.  Those who have decreased intakes, may be taking an oral nutritional supplement or receive enteral nutrition both of which have added vitamins and minerals.

Some people think that if a little is good, then a lot must be better. That doesn’t necessarily apply to vitamins and minerals. In a best-case scenario, taking too much of a certain supplement simply results in the body flushing out the extra compounds it doesn’t need, but this still boils down to wasted money.

It can be challenging knowing when to order and when to refrain.  These supplements may be a helpful intervention for inadequate intake, wound healing, or to treat a diagnosed deficiency.   For instance, someone with a Stg 3 or 4 pressure injury may benefit from a Multivitamin/Mineral supplement to support improved skin integrity.  However, if used improperly, these multivitamin supplements may be costly to the facility while being ineffective and potentially harmful on the resident.

When considering the addition of a nutrient supplement, first look to see how the individual is eating and if those nutrients can be obtained through food, or if on an enteral feeding formula see if it provides 100% of the RDI’s.  If needs are being met orally or enterally, refrain from the additional supplementation.  With facility budgets shrinking and polypharmacy on the rise for older adults, the burden of taking an additional medication that isn’t warranted may be avoidable.