Vitamin D2 supplements appear to reduce the risk of falls among women with a history of falling and low blood vitamin D levels living in sunny climates, especially during the winter, according to a report in the January 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
�Approximately one-third of women older than 65 years fall each year, and 6 percent sustain a fracture as a result of the fall,� the authors write as background information in the article. �In addition, fear of falling is a major problem in older people.�
Richard L. Prince, M.D., of the Sir Charles Gairdner Hospital, Nedlands, Australia, and colleagues conducted a year-long clinical trial of 302 women age 70 to 90 years living in Perth, Australia. Because vitamin D is produced in response to sun exposure and the study was completed in a sunny climate, the researchers selected women with blood vitamin D levels below the median for the area (24 nanograms per milliliter).
All participants had a history of falling in the previous year and received 1,000 milligrams of calcium citrate per day. Half were then randomly assigned to take either 1,000 international units of vitamin D2 (ergocalciferol) and half took an identical placebo. Data on falls were collected from participants every six weeks.
Eighty women (53 percent) in the vitamin D2 group and 95 women (62.9 percent) in the control group fell at least once during the study period. After adjusting for height, which affected the risk of falling and was significantly different between the two groups, vitamin D2 therapy reduced the risk of having at least one fall by 19 percent.
�When those who fell were grouped by the season of first fall or the number of falls they had, ergocalciferol treatment reduced the risk of having the first fall in winter and spring but not in summer and autumn, and reduced the risk of having one fall but not multiple falls,� the authors write.
In 242 community-dwelling seniors, supplementation with either 1000 mg of calcium or 1000 mg of calcium plus vitamin D resulted in a decrease in the number of subjects with first falls of 27% at month 12 and 39% at month 20. Additionally, parameters of muscle function improved significantly.
INTRODUCTION: The efficacy of vitamin D and calcium supplementation on risk of falling in the elderly is discussed controversially. Randomized controlled trials using falls as primary outcome are needed. We investigated long-term effects of calcium and vitamin D on falls and parameters of muscle function in community-dwelling elderly women and men.
METHODS: Our study population consisted of 242 individuals recruited by advertisements and mailing lists (mean [ +/- SD] age, 77 +/- 4 years). All serum 25-hydroxyvitamin D (25[OH]D) levels were below 78 nmol/l. Individuals received in a double blinded fashion either 1000 mg of calcium or 1000 mg of calcium plus 800 IU of vitamin D per day over a treatment period of 12 months, which was followed by a treatment-free but still blinded observation period of 8 months. Falls were documented using diaries. The study took place in Bad Pyrmont, Germany (latitude 52 degrees ) and Graz, Austria (latitude 46 degrees ).
RESULTS: Compared to calcium mono, supplementation with calcium plus vitamin D resulted in a significant decrease in the number of subjects with first falls of 27% at month 12 (RR = 0.73; CI = 0.54-0.96) and 39% at month 20 (RR = 0.61; CI = 0.34-0.76).
Concerning secondary endpoints, we observed significant improvements in quadriceps strength of 8%, a decrease in body sway of 28%, and a decrease in time needed to perform the TUG test of 11%.
DISCUSSION: Combined calcium and vitamin D supplementation proved superior to calcium alone in reducing the number of falls and improving muscle function in community-dwelling older individuals.
Vitamin D May Prevent Falls in Elderly
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