Key Message

Among residents with dementia, positive effects of small-scale homelike models of care on social interaction were observed in 1 non-randomized study, whereas the evidence from relevant primary studies captured in 1 systematic review was mixed. Residents with dementia living in small-scale homelike care facility compared with a traditional nursing home may spend more time in a positive mood or engagement, based on findings from 1 non-randomized study. Evidence captured in 1 systematic review suggested lower use of restraints and psychotropic drugs in small-scale homelike settings compared with traditional nursing homes; however, a non-randomized study published in 2020 found no differences in psychotropic drug use. Associations between homelike models of care and safety outcomes (e.g., COVID-19 infection, fall injuries) suggested a benefit of small-scale homelike long-term care settings over traditional large-scale settings.

Key Message

In community-dwelling older adults who wore hip protectors there was no difference in the risk of hip fractures or pelvic fractures, compared to those who did not wear hip protectors.

Three guidelines were identified that include recommendations around the use of hip protectors in older adults. One guideline suggests that hip protectors should be considered in adults at risk for falls and hip fracture. One guideline conditionally recommends hip protectors for frail older adults in the appropriate environment. One guideline suggests that hip protectors should not be considered in older adults in community settings.

Key Message

The results of 1 systematic review suggest that supplementation with vitamin D may provide some benefit for cancer-related mortality in older adults. It is unclear whether there is a benefit of vitamin D supplementation for all-cause mortality; however, no benefit was found for cardiovascular disease mortality, cardiovascular disease events, or cancer incidence.

There is limited and mixed evidence on the effectiveness of vitamin D supplementation for dementia and mild cognitive impairment in older adults.

The results of 1 systematic review suggest that vitamin D supplementation may provide protection against acute respiratory infections in the overall population; however, this result was not significant in the subgroup of patients older than 65 years.

No evidence-based guidelines were identified regarding vitamin D supplementation for the prevention and/or treatment of cardiovascular disease, cancer, and other conditions in elderly patients residing in long-term care facilities.

Key Message

The relevant publications identified comprised 1 overview of systematic reviews and 2 systematic reviews. There is a suggestion that for seniors living in long-term care facilities, compared to control, vitamin D supplementation, with or without calcium, may reduce the rate of falls and fractures; however, the reductions were not always statistically significant.There were no statistically significant differences in the number of seniors who fell with vitamin D supplementation, with or without calcium, compared with control groups. Findings need to be interpreted with caution, considering the limitations such as primary studies of variable quality (critically low to moderate) and lack of clarity with respect to the type of long-term care setting.No cost-effectiveness studies regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified. No evidence-based guidelines regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified.

Key Message

No evidence was identified regarding the clinical effectiveness of male urethral inserts for the management of male urinary incontinence. No evidence was identified regarding the cost-effectiveness of male urethral inserts for the management of male urinary incontinence.