vitamin D supplementation preventing falls

Vitamin D has direct effects on muscle strength modulated by specific vitamin D receptors in muscle tissue. Clinical trials of older individuals at risk of vitamin D deficiency show benefits form taking vitamin D supplements on strength, funciotn and balance in a dose related pattern,
HA Bischoff-Ferrari et al have reviewed publications in this topic to test the efficacy of supplemental vitamin D and active forms of vitamin D with or without calcium in preventing falls among older individuals.
Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D3 (cholecalciferol) orvitamin D2 (ergocalciferol)) or an active form of vitamin D (la-hydroxyvitamin D3 (la-hydroxycalciferol) or 1,25-dihydroxyvitamin D3 (1,25-dihydroxycholecalciferol)) and with sufficiently specified fall assessment were considered for inclusion.
Eight randomised controlled trials (n=2426) of supplemental vitamin D met their inclusion criteria. Heterogeneity among trials was observed for dose of vitamin D (700-1000 IU/day v200-600 IU/day; P=0.02) and achieved 25-hydroxyvitamin D3 concentration (25(OH)D concentration: WHAT IS ALREADY KNOWN ON THIS TOPIC
Recent systematic reviews suggest a non-significant reduction in falls among individuals receiving supplemental vitamin D
Vitamin D has a direct beneficial effect on muscle, and improved strength and balance in several trials in older persons
A dose of700-1000 IU supplemental vitamin D a day reduced falls by 19%, and by up to 26% with vitamin D3′ within 2-5 months of treatment initiation
Vitamin D may not reduce falls at doses of less than 700 IU a day. Active forms of vitamin D do not appear to be more effective for fall prevention than 700-1000 IU of supplemental vitamin D
HA Bischoff-Ferrari et 2009 Fall prevention with supplemental and active forms of vitamin D: a meta analysis of randomised controlled trials. BMJ vol 339 pp 843-846

Martin Eastwood
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