Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis.
Study Goal
The researchers aimed to determine the effectiveness of vitamin D therapy, often combined with calcium, in preventing falls among older adults.
Results Summary
Vitamin D therapy (200-1,000 IU) reduced falls by 14% compared to calcium or placebo, with greater benefits observed in community-dwelling individuals, those receiving adjunctive calcium, and doses of 800 IU or higher. Post hoc analysis including studies without explicit fall definitions showed a smaller but still significant benefit.
Population
Older adults aged 60 and above, including community-dwelling individuals and those with or without a history of fractures or falls.
Effective Dosage
200-1,000 IU of vitamin D, with adjunctive calcium supplementation noted in some subgroups.
Duration
Longer than 6 months for significant effects.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D therapy (200-1,000 IU) | decrease | falls | older adults (aged > or = 60) | 14% (relative risk (RR)=0.86, 95% confidence interval (CI)=0.79-0.93) | resulted in fewer falls | #1 |
vitamin D therapy | decrease | falls | community-dwelling (aged <80) | - | had significantly fewer falls | #2 |
vitamin D therapy with adjunctive calcium supplementation | decrease | falls | older adults | - | had significantly fewer falls | #3 |
vitamin D therapy | decrease | falls | older adults with no history of fractures or falls | - | had significantly fewer falls | #4 |
vitamin D therapy with duration longer than 6 months | decrease | falls | older adults | - | had significantly fewer falls | #5 |
cholecalciferol | decrease | falls | older adults | - | had significantly fewer falls | #6 |
vitamin D therapy with dose of 800 IU or greater | decrease | falls | older adults | - | had significantly fewer falls | #7 |
vitamin D therapy | decrease | falls | older adults | RR=0.92, 95% CI=0.87-0.98 | yielded smaller benefit | #8 |
vitamin D therapy with adjunctive calcium | decrease | falls | older adults | - | found significant intergroup differences favoring | #9 |
vitamin D treatment | decrease | falls | older adults | - | effectively reduces the risk | #10 |
OBJECTIVES: To systematically review and quantitatively synthesize the effect of vitamin D therapy on fall prevention in older adults. DESIGN: Systematic review and meta-analysis. SETTING: MEDLINE, CINAHL, Web of Science, EMBASE, Cochrane Library, LILACS, bibliographies of selected articles, and previous systematic reviews through February 2009 were searched for eligible studies. PARTICIPANTS: Older adults (aged > or = 60) who participated in randomized controlled trials that both investigated the effectiveness of vitamin D therapy in the prevention of falls and used an explicit fall definition. MEASUREMENTS: Two authors independently extracted data, including study characteristics, quality assessment, and outcomes. The I(2) statistic was used to assess heterogeneity in a random-effects model. RESULTS: Of 1,679 potentially relevant articles, 10 met inclusion criteria. In pooled analysis, vitamin D therapy (200-1,000 IU) resulted in 14% (relative risk (RR)=0.86, 95% confidence interval (CI)=0.79-0.93; I(2)=7%) fewer falls than calcium or placebo (number needed to treat =15). The following subgroups had significantly fewer falls: community-dwelling (aged <80), adjunctive calcium supplementation, no history of fractures or falls, duration longer than 6 months, cholecalciferol, and dose of 800 IU or greater. Meta-regression demonstrated no linear association between vitamin D dose or duration and treatment effect. Post hoc analysis including seven additional studies (17 total) without explicit fall definitions yielded smaller benefit (RR=0.92, 95% CI=0.87-0.98) and more heterogeneity (I(2)=36%) but found significant intergroup differences favoring adjunctive calcium over none (P=.001). CONCLUSION: Vitamin D treatment effectively reduces the risk of falls in older adults. Future studies should investigate whether particular populations or treatment regimens may have greater benefit.