Review: prophylactic use of vitamin D reduces falls in older people

Abstract

Study selection and assessment: randomised controlled trials (RCTs) that compared prophylactic use of any type of vitamin D with a control condition in community dwelling or institutionalised older people (mean age of study participants had to be >60 y) and included a methods section that stated how falls (the outcome) were defined and ascertained. Individual study quality was assessed using specified criteria that included allocation concealment, blinding, and withdrawals.Outcomes: low trauma falls defined as unintentionally coming to rest on the ground, floor, or other lower level. MAIN RESULTS5 RCTs (n = 1237) (mean age 70 y, 81% women) met the selection criteria. Comparisons included cholecalciferol (800 IU/d) plus calcium (1200 mg/d) with calcium (1200 mg/d)(2 RCTs); cholecalciferol (400 IU/d) plus calcium (800-1000 mg/d) from dairy products with placebo (1 RCT); calcitriol (0.5 mg/d) with placebo (1 RCT); and 1a-calcidiol (1 mg/d) with placebo (1 RCT). Meta-analyses using fixed and random effects models showed that fewer participants in the vitamin D group than in the control group had >1 fall (table). Furthermore, a sensitivity meta-analysis of the 10 ''potentially appropriate for inclusion RCTs'' (n = 10 001) showed that fewer participants in the vitamin D group than in the control group had >1 fall (relative risk reduction 13%, 95% CI 4 to 20). CONCLUSIONProphylactic use of vitamin D is effective for reducing falls in older people.

Quality-of-life indicators and falls due to vitamin D deficiency

“… 10 Interestingly, a meta-analysis looking at five randomized controlled trials in prophylactic use of vitamin D in older people showed a decrease in the number of falls in group receiving prophylactic vitamin D with needed to treat =15 (95% CI 9–52). 11 …”