Age and Ageing Advance Access originally published online on July 26, 2007
Age and Ageing 2007 36(5):507-513; doi:10.1093/ageing/afm087
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Does vitamin D stop inpatients falling? A randomised controlled trial
1 Department of Medicine for the Elderly, Mansionhouse Unit, Victoria Infirmary, 21 Mansionhouse Road, Glasgow, G41 3DX, UK
2 Department of Mathematics, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK
3 University of Wollongong, South Eastern Sydney and Illawara Area Health Service, Sydney 2052, Australia
Address correspondence to: Elizabeth Burleigh. Tel: (+44) 141 201 6126; Fax: (+44) 141 201 6159. Email: Liz.Burleigh{at}sgh.scot.nhs.uk
Background: vitamin D deficiency is common in older people and may increase risk of falls and fracture. Hospital inpatients are at particular risk of falling. Previous studies suggest that vitamin D improves neuromuscular function and reduces falls.
Objective: to determine whether routine supplementation with vitamin D plus calcium reduces numbers of fallers and falls in a cohort of hospital admissions while they are inpatients.
Design: randomised, double-blind, controlled study.
Participants: two hundred and five acute admissions >65 years to a geriatric medical unit.
Methods: patients were randomised to intervention of daily vitamin D 800 iu plus calcium 1,200 mg or control group of daily calcium 1,200 mg, until discharge or death.
Results: baseline characteristics were similar in both groups with a median age 84 years and a median length of stay = 30 days (IQR 14.75–71.00). In a pre-selected sub-group (54/205 participants), median admission vitamin D level = 22.00 nmol/l (IQR 15.00–30.50). This did not significantly increase in the treatment versus control group. Median study drug adherence = 88%, with no significant difference between study groups (Mann–Whitney: P = 0.711). Although there were fewer fallers in the vitamin D cohort, this did not reach statistical significance (vitamin D: calcium = 36:45 fallers; RR 0.82 (CI 0.59–1.16). Neither the mean number of falls (vitamin D: calcium = 1.040:1.155; Mann–Whitney P = 0.435) or time to first fall (Log-rank test P = 0.377) differed between groups.
Conclusions: in a population of geriatric hospital inpatients, vitamin D did not reduce the number of fallers. Routine supplementation cannot be recommended to reduce falls in this group.
Keywords: vitamin D, accidental falls, elderly, hospitalisation, randomised controlled trial
Received 21 June 2006; accepted in revised form 3 April 2007.