Vitamin D supplementation reduces the risk of fall in the vitamin D deficient elderly: An updated meta-analysis.
Study Goal
The researchers aimed to determine whether vitamin D supplementation alone or in combination with calcium reduces the risk of falls in older adults.
Results Summary
The study found that vitamin D supplementation alone did not reduce fall risk overall but showed benefit in individuals with low baseline 25(OH)D levels (<50 nmol/L). Combined vitamin D (700-1000 IU daily) and calcium (1000-1200 mg daily) supplementation reduced fall risk by 12%.
Population
Older adults (specific age range not specified).
Effective Dosage
Calcium: 1000-1200 mg daily; Vitamin D: 700-1000 IU daily.
Duration
Not specified in the abstract.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D supplementation alone | no change | falls | participants | RR 1.00, 95% CI 0.95 to 1.05 | did not show a reduced risk | #1 |
vitamin D supplementation alone | decrease | fall risk | participants with baseline serum 25(OH)D concentration less than 50 nmol/L | RR 0.77, 95% CI 0.61 to 0.98 | resulted in a reduction | #2 |
combined supplementation of vitamin D and calcium | decrease | risk of fall | participants | 12% reduction (RR 0.88, 95% CI 0.80 to 0.97) | showed a reduction | #3 |
vitamin D supplementation alone | no change | fall risk | old adults with 25(OH)D levels higher than 50 nmol/L | - | has no effect | #4 |
vitamin D supplementation alone | decrease | prevention of falls | old adults with 25(OH)D levels lower than 50 nmol/L | - | does have a benefit | #5 |
INTRODUCTION: Vitamin D supplementation has been widely recommended to prevent falls. However, considerable controversy exists regarding the association of such supplementation and fall risk. Previous meta-analyses yielded inconsistent results because of differences in the baseline of 25-hydroxyvitamin D [25(OH)D] and dose of vitamin D and use of vitamin D or in combination with calcium in different studies. Furthermore, some studies published recently were not included in the previous meta-analyses. Therefore, an updated and comprehensive meta-analysis is warranted. METHODS: We systematically searched several literature databases including PubMed and the Embase from inception to September 2020. The protocol for this meta-analysis was registered with PROSPERO (CRD42021226380). Randomized clinical trials (RCTs) reporting the effect of vitamin D supplementation alone or with calcium on fall incidence were selected from studies. Qualitative and quantitative information was extracted; the random-effects model was conducted to pool the data for fall; statistical heterogeneity was assessed using the I RESULTS: Of the citations retrieved, 31 eligible studies involving 57 867 participants met inclusion criteria, reporting 17 623 falls. A total of 21 RCTs of vitamin D alone and 10 RCTs of vitamin D plus calcium were included in the meta-analysis. The meta-analysis of 21 RCTs (51 984 participants) of vitamin D supplementation alone (daily or intermittent doses of 400-60 000 IU) did not show a reduced risk of falls (The risk ratio [RR] 1.00, 95% confidence intervals [CI] 0.95 to 1.05) compared to placebo or no treatment. Subgroup analyses showed that the baseline of serum 25(OH)D concentration less than 50 nmol/L resulted in a reduction of fall risk (RR 0.77, 95% CI 0.61 to 0.98). In contrast, the meta-analysis of 10 RCTs (5883 participants) of combined supplementation of vitamin D (daily doses of 700-1000 IU) and calcium (daily doses of 1000-1200 mg) showed a 12% reduction in the risk of fall (RR 0.88, 95% CI 0.80 to 0.97). CONCLUSIONS: The combination of vitamin D and calcium have beneficial effects on prevention falls in old adults. Although vitamin D supplementation alone has no effect on fall risk in old adults with 25(OH)D levels higher than 50 nmol/L, vitamin D supplementation alone does have a benefit on prevention of falls in old adults with 25(OH)D levels lower than 50 nmol/L.