Fractures due to with falls is an important cause of morbidity and mortality in elderly people. Some 30% of active old people aged over 65 years and 50% of those cared for in institutions fall each year. Ninety percent of hip fractures in the elderly happen during falls and about 5% of the elderly population suffers a fall related fracture each year. This vulnerability is increased by osteoporosis which also increases with advancing age, Osteoporosis primarily affects postmenopausal women, due to the decline in bone mass and changes in bone architecture with oestrogen deficiency
Osteoporosis is an under-diagnosed and under-treated condition. In American women less than 15% of American women with osteoporosis receive treatment.. Most high-risk patients, e.g. after a hip fracture, are not treated for their osteoporosis; As the population ages, osteoporosis will become more prevalent with attendant costs of preventing and treating the disease rising
Effective methods of reducing or preventing falls and fractures in older people are needed, and vitamin D supplementation is highly recommended as a standard preventative measure in osteoporosis management.” Vitamin D is essential for the maintenance of calcium homeostasis. It is synthesized in the skin after exposure to sunlight, and is also obtained through the diet. Vitamin D inadequacy is common in elderly people, particularly in countries where it is not commonly added to food.
Serum 2 5-hydroxy vitamin D (25(OH)D), reflects vitamin D status, and levels However, the independent effect of vitamin D is less well understood for osteoporosis or for falls. A study by Jackson et al QJM 2007, vol 100 pp 185-192 used a meta-analysis to evaluate how supplementation with vitamin D alone affects the risk of falling, and sustaining vertebral and non-vertebral fractures, primarily in postmenopausal women. All had reduced 25(OH)D serum concentrations and subsequently received 300 to 800 IU each day.
There is some benefit from taking vitamin D3 supplements in reducing the incidence of falls which must be reflected in reduced harm to these older individuals.
Jackson et al QJM 2007, vol 100 pp 185-192
- Martin Eastwood