Age and Ageing Advance Access originally published online on April 26, 2006
Age and Ageing 2006 35(5):482-486; doi:10.1093/ageing/afj080
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Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation
1 Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and The London, Queen Mary’s School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK
2 Geriatric Medicine Group, University of Southampton Medical School, Southampton SO16 6YD, UK
Address correspondence to: M. Law. Email: m.r.law{at}qmul.ac.uk
Objectives: to determine whether vitamin D supplementation reduces the risk of fracture or falls in elderly people in care home accommodation.
Design: a randomised controlled trial of cluster design.
Setting and subjects: 223 residential units (mainly identical 30-bedded units), within 118 homes for elderly people throughout Britain, with 3,717 participating residents (76% women, average age 85 years). The units provided mainly or entirely residential care (35% of residents), nursing care (42%) or care for elderly mentally infirm (EMI) residents (23%).
Methods: participants were randomly allocated by residential unit (cluster design) to a treated group offered ergocalciferol 2.5 mg every 3 months (equivalent to a daily dose of 1,100 IU), or to a control group. Fractures were reported by staff and confirmed in hospital, and routinely collected data on reported falls were obtained.
Results: after median follow-up of 10 months (interquartile range 7–14 months), 64 (3.6%) of 1,762 vitamin D-treated residents and 51 (2.6%) of 1,955 controls had one or more non-vertebral fractures, and 24 (1.3%) and 20 (1.0%), respectively, had a hip fracture. The proportion reporting at least one fall was 44% in vitamin D-treated and 43% in control residents. The differences between the vitamin D and control groups were not statistically significant. The incidence of all non-vertebral fractures in the care homes (3.2% per year) and of hip fractures (1.1% per year) was low, similar to rates in elderly people in sheltered accommodation, and the pre-treatment serum 25-hydroxy vitamin D concentration was high [median 47 nmol/l, measured in a 1% (n = 18) sample].
Conclusions: we found no evidence that vitamin D prevents fractures or falls in elderly people in care home accommodation.
Keywords: vitamin D, fractures, hip fractures, falls, elderly, prevention
Received October 6, 2005; accepted in revised form February 6, 2006.
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