A randomized, controlled pilot study of the effects of vitamin D supplementation on balance in Parkinson's disease: Does age matter?

Abstract

ObjectivesTo explore if short term, high dose vitamin D supplementation is safe and improves balance in persons with Parkinson's disease (PD).MethodsA pilot randomized, double-blind intervention trial to measure the effects of 16 weeks of high dose vitamin D (10,000 IU/day) on balance as well as other motor and non-motor features of PD. We measured balance, gait, strength, falls, cognition, mood, PD severity, and quality of life before and after 16 weeks of high dose vitamin D supplementation or placebo. All participants also received 1000 mg calcium once daily.ResultsFifty-one randomized participants completed sixteen weeks of high dose vitamin D supplementation or placebo. The intervention resulted in a rise in serum concentrations of vitamin D (25-OH) (30.2 ng/ml to 61.1 ng/ml) and was well tolerated with no serious adverse events. Serum vitamin D (25-OH) levels rose steadily and did not suggest a leveling off at the end of the 16 weeks. There was not an improvement in the primary endpoint, balance as measured by the Sensory Organization Test (p = 0.43). A post hoc analysis examining treatment effects in younger (ages 52–66) versus older (ages 67–86) participants found a significant improvement in the SOT of 10.6 points in the younger half of the cohort (p = 0.012).ConclusionsShort term, high dose vitamin D supplementation appears safe in persons with PD, but did not significantly improve balance as measured with the Sensory Organization Test in this pilot study population. A post hoc analysis suggests that vitamin D may have potential for improving balance in a younger population with PD. High dose vitamin D supplementation in PD needs further study especially in light of new research suggesting that mega doses and even moderate doses (as low as 4000IU a day) may increase falls in an older populations.Trial registrationClinicalTrials.gov: NCT01119131.

The relationships of vitamin D, vitamin D receptor gene polymorphisms, and vitamin D supplementation with Parkinson’s disease

“…The most important studies on vitamin D supplementation in PD patients are shown in Table 2. An interventional trial supported the role of vitamin D in postural balance of PD patients and suggested that daily supplementation of vitamin D could improve the balance of younger PD patients [148]. Other studies have also confirmed that supplemental 25(OH)D has beneficial effects on strength and balance in older adults [149].…”

“…However, the complex automatic postural response not only requires muscle function, but also involves the spinal cord, midbrain/brainstem, and cerebellum/basal ganglia/cerebral cortex [150,151]. In addition, vitamin D 3 supplementation has an age-dependent effect on PD [148]. Another randomized controlled trial of vitamin D supplementation found that vitamin D 3 supplementation may retard the progression of PD for a short period in patients with FokI CT and TT genotypes [41].…”

The Effects of Vitamin D Deficiency on Neurodegenerative Diseases

“…In line with this, a double-blind, placebo-controlled intervention study from Suzuki and colleagues, including 114 PD patients, was able to reveal that supplementation of 1200 IU vitamin D 3 /day prevents disease progression in a VDR FokI genotype-dependent manner [87]. Moreover, high-dose supplementation of vitamin D (10,000 IU/day) resulted in significant improved balance measured via sensory organization test in PD patients with an age of 52-66 but not in older individuals [88].…”

Correlation between serum 25(OH) vitamin D level and sleep quality in elderly patients with type 2 diabetes

“…10 The Endocrine Society Clinical Practice Guideline defines Vitamin D deficiency as 25(OH)D level <20 ng/mL and insufficiency as 21 to 29 ng/mL. 11 Some studies have linked deficient 25(OH) vitamin D to neuropsychological diseases such as sleep disorders [12][13][14] , which showed that 25…”