Age and Ageing Vol. 33 No. 6 © British Geriatrics Society 2004; all rights reserved
Research Paper |
Vitamin D supplementation improves neuromuscular function in older people who fall
1 Elderly Day Hospital, Thomas Guy House, Guys Hospital, St Thomas Street, London SE1, UK
2 Clinical Age Research Unit, Department of Health Care of the Elderly, New Medical School, King's College Hospital, Bessemer Road, London SE5 9PJ, UK
3 Physiotherapy Rehabilitation Unit, East Dulwich Hospital, East Dulwich Grove, East Dulwich, London, UK
4 Clinical Biochemistry, King's College Hospital, Guy's, King's and St Thomas' School of Medicine, Bessemer Road, London SE5 9PJ, UK
5 Care of the Elderly, North Bristol NHS Trust, Westbury on Trym, Bristol BS10 5NB, UK
Address correspondence to: J. Dhesi. Fax: (+44) 20 7188 2096. Email: jugdeep.dhesi{at}gsst.nhs.uk
Abstract
Background: vitamin D supplementation reduces the incidence of fractures in older adults. This may be partly mediated by effects of vitamin D on neuromuscular function.
Objective: to determine the effects of vitamin D supplementation on aspects of neuromuscular function known to be risk factors for falls and fractures.
Design: randomised, double-blind, placebo-controlled study.
Setting: falls clinic taking referrals from general practitioners and accident and emergency department.
Subjects: 139 ambulatory subjects (
65 years) with a history of falls and 25-hydroxyvitamin D (25OHD) 
12 µg/l.
Intervention: patients were randomised to receive a single intramuscular injection of 600,000 i.u. ergocalciferol or placebo.
Outcome measures: assessments including biochemistry, postural sway, choice reaction time (CRT), aggregate functional performance time (AFPT), and quadriceps strength were carried out at baseline and 6 months post-intervention.
Results: baseline characteristics were comparable between both groups. 25OHD in the treatment group increased significantly at 6 months. AFPT deteriorated in the control group and improved in the intervention group, representing a significant difference between groups (+6.6 s versus –2.0 s, t = 2.80, P < 0.05). Similar changes were observed for CRT (–0.06 s versus +0.41 s, t = –2.52, P < 0.01) and postural sway (+0.0025 versus –0.0138, t = 2.35, P < 0.02). There was no significant difference in muscle strength change between groups (–10 N versus –2 N, t = –1.26, ns). A significant correlation between change in AFPT and change in 25OHD levels was observed (r = 0.19, P = 0.03). There was no significant difference in the number of falls (0.39 versus 0.24, t = 1.08, P = 0.28) or fallers (14 versus 11, P = 0.52) between two groups.
Conclusions: vitamin D supplementation, in fallers with vitamin D insufficiency, has a significant beneficial effect on functional performance, reaction time and balance, but not muscle strength. This suggests that vitamin D supplementation improves neuromuscular or neuroprotective function, which may in part explain the mechanism whereby vitamin D reduces falls and fractures.
Keywords: vitamin D, muscle, accidental falls, aged, 25-hydroxyvitamin D3, elderly
Received May 13, 2003; Revision received July 8, 2004. accepted in revised form July 8, 2004.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. J. Llewellyn, K. M. Langa, and I. A. Lang Serum 25-Hydroxyvitamin D Concentration and Cognitive Impairment J Geriatr Psychiatry Neurol, September 1, 2009; 22(3): 188 - 195. [Abstract] [PDF]
|
|
|
|
 |
|
 J. L. Carter, S. E. O'Riordan, G. L. Eaglestone, M. P. Delaney, and E. J. Lamb Bone mineral metabolism and its relationship to kidney disease in a residential care home population: a cross-sectional study Nephrol. Dial. Transplant., November 1, 2008; 23(11): 3554 - 3565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Cauley, A. Z. LaCroix, L. Wu, M. Horwitz, M. E. Danielson, D. C. Bauer, J. S. Lee, R. D. Jackson, J. A. Robbins, C. Wu, et al. Serum 25-Hydroxyvitamin D Concentrations and Risk for Hip Fractures Ann Intern Med, August 19, 2008; 149(4): 242 - 250. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Prince, N. Austin, A. Devine, I. M. Dick, D. Bruce, and K. Zhu Effects of Ergocalciferol Added to Calcium on the Risk of Falls in Elderly High-Risk Women Arch Intern Med, January 14, 2008; 168(1): 103 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Burleigh, J. McColl, and J. Potter Does vitamin D stop inpatients falling? A randomised controlled trial Age Ageing, September 1, 2007; 36(5): 507 - 513. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Schwalfenberg Not enough vitamin D: Health consequences for Canadians Can Fam Physician, May 1, 2007; 53(5): 841 - 854. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. K. Houston, M. Cesari, L. Ferrucci, A. Cherubini, D. Maggio, B. Bartali, M. A. Johnson, G. G. Schwartz, and S. B. Kritchevsky Association Between Vitamin D Status and Physical Performance: The InCHIANTI Study J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2007; 62(4): 440 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Rapuri, J. C. Gallagher, and L. M. Smith Smoking Is a Risk Factor for Decreased Physical Performance in Elderly Women J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2007; 62(1): 93 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. M. Hylek, J. D'Antonio, C. Evans-Molina, C. Shea, L. E. Henault, and S. Regan Translating the Results of Randomized Trials into Clinical Practice: The Challenge of Warfarin Candidacy Among Hospitalized Elderly Patients With Atrial Fibrillation Stroke, April 1, 2006; 37(4): 1075 - 1080. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. Holick High Prevalence of Vitamin D Inadequacy and Implications for Health Mayo Clin. Proc., March 1, 2006; 81(3): 353 - 373. [Abstract] [Full Text] [PDF]
|
|