Does vitamin D stop inpatients falling? A randomised controlled trial

Burleigh, Elizabeth

doi:10.1186/isrctn18282824

Cited by 5 publications

(19 citation statements)

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“…As a consequence, categorizing populations with either too low or too high threshold concentrations may have reduced the association (if any) between vitamin D and falling. This finding is also consistent with results from supplementation studies as most inconclusive trials, in which it was found that vitamin D supplementation did not prevent falling, recruited participants with serum 25OHD either below 10 ng mL −1 or as a high as 30 ng mL −1 , and thus, their risk of falling might have been at least in part independent of vitamin D status. Finally, this is also in line with research into nonbone effects of vitamin D, because the greatest risk of cancer, infections and cardiovascular and metabolic diseases appears to be associated with 25OHD concentrations below 20 ng mL −1 .…”

Section: Critical Literature Analysissupporting

confidence: 87%

Questioning vitamin D status of elderly fallers and nonfallers: a meta‐analysis to address a ‘forgotten step’

Annweiler

Beauchet

2014

J Intern Med

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Background. Previous meta-analyses to determine the efficacy of vitamin D supplementation to prevent falls in the elderly have shown mixed results. Inconsistencies might depend on the dose of supplements, suggesting that serum 25-hydroxyvitamin D (25OHD) concentration could influence the risk of falling. Our objective was to systematically review and quantitatively analyse the relationship between serum 25OHD concentration and the occurrence of falls.

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Section: Critical Literature Analysissupporting

confidence: 87%

Questioning vitamin D status of elderly fallers and nonfallers: a meta‐analysis to address a ‘forgotten step’

Annweiler

Beauchet

2014

J Intern Med

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“…() identified three additional RCTs on bone health (Bunout et al., ; Burleigh et al., ; Lyons et al., ), two of which investigated fracture risk. These did not show significant effects of either vitamin D 2 (four‐monthly dose equivalent to 20.6 μg/day) compared with placebo, or of vitamin D 3 (20 μg/day) plus calcium compared with calcium, in reducing the risk of total fractures, in a cohort of hospital inpatients (Burleigh et al., ) and in older adults living in residential or care homes (Lyons et al., ). IOM () identified two additional RCTs (Salovaara et al., ; Sanders et al., ).…”

Section: Appendix B – Summary Of the Evidence Considered By The Iom Tmentioning

confidence: 99%

“…() and two RCTs (Bischoff‐Ferrari et al., ; Sanders et al., ) published afterwards, IOM () considered that no consistent result was found from randomised trials that tested for effects of vitamin D with and without calcium on reduction in risk for falls . IOM considered 20 randomised trials on oral doses (Graafmans et al., ; Pfeifer et al., , ; Chapuy et al., ; Bischoff‐Ferrari et al., , , ; Trivedi et al., ; Flicker et al., ; Grant et al., ; Larsen et al., ; Law et al., ; Broe et al., ; Burleigh et al., ; Prince et al., ) or injected doses (Latham et al., ; Dhesi et al., ; Harwood et al., ; Smith et al., ; Sanders et al., ). These RCTs had heterogeneous designs, e.g.…”

Section: Appendix B – Summary Of the Evidence Considered By The Iom Tmentioning

confidence: 99%

Dietary reference values for vitamin D

2016

EFSA Journal

227

135

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Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derived dietary reference values (DRVs) for vitamin D. The Panel considers that serum 25(OH)D concentration, which reflects the amount of vitamin D attained from both cutaneous synthesis and dietary sources, can be used as a biomarker of vitamin D status in adult and children populations. The Panel notes that the evidence on the relationship between serum 25(OH)D concentration and musculoskeletal health outcomes in adults, infants and children, and adverse pregnancy-related health outcomes, is widely variable. The Panel considers that Average Requirements and Population Reference Intakes for vitamin D cannot be derived, and therefore defines adequate intakes (AIs), for all population groups. Taking into account the overall evidence and uncertainties, the Panel considers that a serum 25 (OH)D concentration of 50 nmol/L is a suitable target value for all population groups, in view of setting the AIs. For adults, an AI for vitamin D is set at 15 lg/day, based on a meta-regression analysis and considering that, at this intake, the majority of the population will achieve a serum 25(OH)D concentration near or above the target of 50 nmol/L. For children aged 1-17 years, an AI for vitamin D is set at 15 lg/day, based on the meta-regression analysis. For infants aged 7-11 months, an AI for vitamin D is set at 10 lg/day, based on trials in infants. For pregnant and lactating women, the Panel sets the same AI as for non-pregnant non-lactating women, i.e. 15 lg/day. The Panel underlines that the meta-regression was done on data collected under conditions of assumed minimal cutaneous vitamin D synthesis. In the presence of cutaneous vitamin D synthesis, the requirement for dietary vitamin D is lower or may even be zero. In line with EFSA's policy on declarations of interest, Panel member Harry McArdle did not participate in the development and adoption of this scientific opinion.Acknowledgements: The Panel wishes to thank the members of the Working Group on dietary reference values for vitamins: Christel Lamberg-Allardt, Monika Neuh € auser-Berthold, Gra _ zyna Nowicka, Kristina Pentieva, Hildegard Przyrembel, Inge Tetens, Daniel Tom e and Dominique Turck for the preparatory work on this scientific opinion and EFSA staff members: Laura Ciccolallo, C eline Dumas, Lucia Fabiani and Laura Martino for the support provided to this scientific opinion.

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“…It was not blinded, and the control group had fall reduction interventions instituted, as this was the hospital standard. 61 The other negative studies were small, ranging from 54 62 to 205 patients, 60 and may have insufficient power to determine a clinical significance.…”

Section: Interventionsmentioning

confidence: 99%

Inpatient Falls

Cumbler

Simpson

Rosenthal

et al. 2013

The Neurohospitalist

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In this 2 part series, analysis of the risk stratification tools that are available, definition for the scope of the problem, and potential solutions through a review of the literature are presented. A systematic review was used to identify articles for risk stratification and interventions. Three risk stratification systems are discussed, St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, Morse Fall Scale, and the Hendrich Fall Risk Model. Of these scoring systems, the Hendrich Fall Risk Model is the easiest to use and score. Predominantly, multifactorial interventions are used to prevent patient falls. Education and rehabilitation are common themes in studies with statistically significant results. The second article presents a guide to implementing a quality improvement project around hospital falls. A 10-step approach to Plan-Do-Study-Act (PDSA) cycles is described. Specific examples of problems and analysis are easily applicable to any institution. Furthermore, the sustainability of interventions and targeting new areas for improvement is discussed. Although specific to falls in the hospitalized patient, the goal is to present a stepwise approach which is broadly applicable to other areas requiring quality improvement.

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Does vitamin D stop inpatients falling? A randomised controlled trial

Cited by 5 publications

References 0 publications

Questioning vitamin D status of elderly fallers and nonfallers: a meta‐analysis to address a ‘forgotten step’

Questioning vitamin D status of elderly fallers and nonfallers: a meta‐analysis to address a ‘forgotten step’

Dietary reference values for vitamin D

Inpatient Falls

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