Fall prevention and vitamin D in the elderly: an overview of the key role of the non-bone effects

Annweiler, Cédric; Montero‐Odasso, Manuel; Schott, Anne-Marie; Berrut, Gilles; Fantino, Bruno; Beauchet, Olivier

doi:10.1186/1743-0003-7-50

Cited by 117 publications

(99 citation statements)

References 124 publications

(219 reference statements)

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“…It is the case that 25(OH)D was shown to predict lower-extremity function in both active and inactive persons aged ‡ 60 years (74) and a meta analysis of RCT of vitamin D supplementation showed a > 20% reduced risk of falls among ambulatory or institutionalised elders (75) . Furthermore, the more recent suggestion in a systematic review that the association between vitamin D and physical performance remains controversial (76) appeared to be resolved by an updated meta analysis of RCT in which studies were separated according to intervention dose (77) . This showed that supplemental vitamin D reduced the risk of falling among older individuals by 19% for interventions ‡ 17 .…”

Section: Vitamin D: Strength Preservation In Musclementioning

confidence: 99%

Nutrition and sarcopenia: evidence for an interaction

Millward

2012

Proc. Nutr. Soc.

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Nutritional interventions that might influence sarcopenia, as indicated by literature reporting on sarcopenia per se as well as dynapenia and frailty, are reviewed in relation to potential physiological aetiological factors, i.e. inactivity, anabolic resistance, inflammation, acidosis and vitamin D deficiency. As sarcopenia occurs in physically active and presumably well-nourished populations, it is argued that a simple nutritional aetiology is unlikely and unequivocal evidence for any nutritional influence is extremely limited. Dietary protein is probably the most widely researched nutrient but only for frailty is there one study showing evidence of an aetiological influence and most intervention studies with protein or amino acids have proved ineffective with only a very few exceptions. Fish oil has been shown to attenuate anabolic resistance of muscle protein synthesis in one study. There is limited evidence for a protective influence of antioxidants and inducers of phase 2 proteins on sarcopenia, dynapenia and anabolic resistance in human and animal studies. Also fruit and vegetables may protect against acidosis-induced sarcopenia through their provision of dietary potassium. While severe vitamin D deficiency is associated with dynapenia and sarcopenia, the evidence for a beneficial influence of increasing vitamin D status above the severe deficiency level is limited and controversial, especially in men. On this basis there is insufficient evidence for any more specific nutritional advice than that contained in the general healthy lifestyle-healthy diet message: i.e. avoiding inactivity and low intakes of food energy and nutrients and maintain an active lifestyle with a diet providing a rich supply of fruit and vegetables and frequent oily fish. Aging: Dynapenia: Inactivity: Anabolic resistance: DietIn a recent consensus paper sarcopenia (1) was defined as the age-associated loss of skeletal muscle mass and function, a complex syndrome associated with muscle mass loss alone or in conjunction with increased fat mass. It was argued that although cachexia may be a component of sarcopenia, the two conditions are not the same. What was not discussed in this paper was the difference between sarcopenia and dynapenia which is important in terms of the clinical relevance of the condition. Thus Jansonn (2) points out that the data on the functional implications of sarcopenia are inconsistent, possibly because we do not always recognise the distinction between sarcopenia, loss of muscle mass and dynapenia and loss of muscle strength. These, he argues, are physiologically different with dynapenia the main predictor of functional impairment and/or physical disability, chronic disease and mortality risk, to the extent that research and clinical emphasis should be placed more on dynapenia than on sarcopenia. In fact this argument can, to some extent be extended to include frailty, a much more general term for a collection

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Section: Vitamin D: Strength Preservation In Musclementioning

confidence: 99%

Nutrition and sarcopenia: evidence for an interaction

Millward

2012

Proc. Nutr. Soc.

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“…(14) Supplementation of vitamin D has been shown to improve relative muscle fiber composition and fibers area of type IIa muscle fibers, and has also been reported to have an effect on antigravity muscles, supported by the improvement in postural equilibrium tests. (11) Although there is no consensus of which vitamin D level is defined as deficient, (15) it has been suggested that serum vitamin D level should be at least 75 nmol/L, which implies numerous elderly in the community and LTC facilities would be deficient in Vitamin D, thus supplementation would be warranted. (16) It is a safe supplement to prescribe without significant adverse effects prescribed at standard doses or supratherapeutic doses.…”

Section: Introductionmentioning

confidence: 99%

“…Vitamin D can also be obtained through diet, which consists of cholecalciferol and ergocalciferol (vitamin D 2 (10) A recent review has suggested histological and interventional evidence between vitamin D deficiency and muscle weaknesses. (11) Severe vitamin D deficiency to the extent of osteomalacia causes proximal and lower limb muscle weaknesses, with histological evidence of predominant type II muscle atrophy, widening of interfibrillary spaces, fatty infiltration, fibrosis, and the presence of glycogen granules without signs of inflammatory reaction. In less extreme cases, 30% of muscle biopsies revealed features of vitamin D insufficiency-related myopathies.…”

Section: Introductionmentioning

confidence: 99%

Association Between Vitamin D Dosing Regimen and Fall Prevention in Long-term Care Seniors

Chua¹,

Wong

2011

Can Geri J

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IntroductionThe effectiveness of vitamin D in reducing falls among longterm care (LTC) seniors remains nonconclusive. We reviewed how vitamin D dosing regimen could affect rate of fall and number of fallers among LTC seniors.MethodsWe conducted a systematic literature review. Studies were selected by two independent reviewers based on study characteristics (age 75 or older), quality assessment (primary analysis randomized controlled trials), and outcome (rate of fall and number of fallers). Analyses of all trials following trials using daily standard dosage (800–1000 IU) only were performed to compare daily standard dosage with intermittent supratherapeutic dosage in fall prevention.ResultsSeventy-nine studies were identified, with 28 selected by reviewers (kappa 0.98), and four RCT were conducted in LTC. Daily standard dosage provides greater reduction in rate of fall by 16%, which was statistically significant. However, reduction in number of fallers remained statistically insignificant even taking dosing regimen into account.ConclusionsDaily standard dosage of vitamin D has greater benefits in reducing fall rate than that of intermittent supratherapeutic doses, but not in number of fallers. This could imply that vitamin D is useful in preventing fall recurrence rather than first fall. Prospective studies randomizing LTC seniors to different dosing regimens are warranted.

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“…9 Vitamin D supplementation reduces the risk of falls in older adults through effects on muscle and the nervous system (both central and peripheral), whereby it improves gait and balance. 8,10 Vitamin D supplementation of > 800 IU per day, aiming to achieve 25(OH)D levels of at least 30 ng/ml, was somewhat favourable in preventing hip fractures and nonvertebral fractures in persons who were 65 years and older. 11 …”

Section: Skeletal Healthmentioning

confidence: 99%

An interesting D-lemma: what is all the excitement about vitamin D?

Conradie

Ascott-Evans

2014

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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There has been a dramatic interest in the importance of vitamin D, "the sunshine vitamin", in the past few years with regard to its impact on various aspects of health and disease. Research into well-known skeletal effects, as well as extra-skeletal effects, has been overwhelming. At times it has been difficult to make informed clinical decisions regarding replacement, if needed at all. This article aims to provide the family practitioner with a summary of the most important clinical effects of vitamin D, as well as give guidelines on testing for possible deficiency and consideration of replacement thereof.Peer reviewed.

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Fall prevention and vitamin D in the elderly: an overview of the key role of the non-bone effects

Cited by 117 publications

References 124 publications

Nutrition and sarcopenia: evidence for an interaction

Nutrition and sarcopenia: evidence for an interaction

Association Between Vitamin D Dosing Regimen and Fall Prevention in Long-term Care Seniors

An interesting D-lemma: what is all the excitement about vitamin D?

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