Effects of vitamin D, omega-3 fatty acids, and a simple home strength exercise program on fall prevention: the DO-HEALTH randomized clinical trial.
Study Goal
The researchers aimed to determine whether daily supplemental vitamin D, alone or in combination with omega-3s and a home exercise program, could reduce the incidence of falls among generally healthy older adults.
Results Summary
The study found that vitamin D supplementation had no benefit on total falls among healthy, active, and vitamin D-replete older adults. The primary endpoint showed no significant reduction in fall incidence with vitamin D.
Population
Community-dwelling adults aged 70 years and older, generally healthy and active, from Switzerland, Germany, Austria, France, and Portugal.
Effective Dosage
2000 international units/day of vitamin D3
Duration
3 years
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
daily supplemental vitamin D | no change | total falls | generally healthy and active older adults | no significant change | had no benefit | #1 |
simple home exercise program (SHEP) | no change | total falls | generally healthy and active older adults | no significant change | had no benefit | #2 |
daily supplemental marine omega-3s fatty acids | decrease | total falls | generally healthy and active older adults | 10% | reduced | #3 |
daily supplemental vitamin D | no change | injurious falls | generally healthy and active older adults | no significant change | had no benefit | #4 |
simple home exercise program (SHEP) | no change | injurious falls | generally healthy and active older adults | no significant change | had no benefit | #5 |
daily supplemental marine omega-3s fatty acids | decrease | incidence of total falls | generally healthy, active, and vitamin D-replete older adults | - | may have a modest benefit | #6 |
daily high dose of vitamin D | no change | incidence of total falls | generally healthy, active, and vitamin D-replete older adults | - | had no benefit | #7 |
simple home exercise program (SHEP) | no change | incidence of total falls | generally healthy, active, and vitamin D-replete older adults | - | had no benefit | #8 |
BACKGROUND: The roles of vitamin D, omega-3 fatty acids, and home exercise on fall prevention among generally healthy and active older adults are unclear. OBJECTIVES: We tested the effects of daily supplemental vitamin D, daily supplemental marine omega-3s fatty acids, and a simple home exercise program (SHEP), alone or in combination, on the incidences of total and injurious falls among generally healthy older adults. METHODS: We performed a 2 × 2 × 2 factorial-design randomized controlled trial among 2157 community-dwelling adults aged 70 years and older, who had no major health events in the 5 years prior to enrolment, recruited from Switzerland, Germany, Austria, France, and Portugal between December 2012 and November 2014. Participants were randomly assigned to supplementation with 2000 international units/day of vitamin D3 and/or 1 g/day of marine omega-3s, and/or a SHEP compared with placebo and/or control exercise over 3 years. The primary endpoint for the present fall analysis was the incidence rate of total falls. Falls were recorded prospectively throughout the trial. Since there were no interactions between treatments, the main effects are reported based on a modified intent-to-treat analysis. RESULTS: Of 2157 randomized participants, 1900 (88%) completed the study. The mean age was 74.9 years, 61.7% were women, 40.7% had a serum 25-hydroxyvitamin D concentration < 20 ng/ml, and 83% were at least moderately physically active. In total, 3333 falls were recorded over a median follow-up of 2.99 years. Overall, vitamin D and the SHEP had no benefit on total falls, whilst supplementation with omega-3s compared to no omega-3 supplementation reduced total falls by 10% (incidence rate ratio = 0.90; 95% CI, 0.81-1.00; P = 0.04). CONCLUSIONS: Among generally healthy, active, and vitamin D-replete older adults, omega-3 supplementation may have a modest benefit on the incidence of total falls, whilst a daily high dose of vitamin D or a SHEP had no benefit.