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J Am Geriatr Soc. 2010 Jul;58(7):1299-310. doi: 10.1111/j.1532-5415.2010.02949.x. Epub 2010 Jun 23.

Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis.

Author information

  • 1Division of Endocrinology and Metabolism, Department ofMedicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA. rrastogi@jhmi.edu

Abstract

OBJECTIVES:

To systematically review and quantitatively synthesize the effect of vitamin D therapy on fall prevention in older adults.

DESIGN:

Systematic review and meta-analysis.

SETTING:

MEDLINE, CINAHL, Web of Science, EMBASE, Cochrane Library, LILACS, bibliographies of selected articles, and previous systematic reviews through February 2009 were searched for eligible studies.

PARTICIPANTS:

Older adults (aged > or = 60) who participated in randomized controlled trials that both investigated the effectiveness of vitamin D therapy in the prevention of falls and used an explicit fall definition.

MEASUREMENTS:

Two authors independently extracted data, including study characteristics, quality assessment, and outcomes. The I(2) statistic was used to assess heterogeneity in a random-effects model.

RESULTS:

Of 1,679 potentially relevant articles, 10 met inclusion criteria. In pooled analysis, vitamin D therapy (200-1,000 IU) resulted in 14% (relative risk (RR)=0.86, 95% confidence interval (CI)=0.79-0.93; I(2)=7%) fewer falls than calcium or placebo (number needed to treat =15). The following subgroups had significantly fewer falls: community-dwelling (aged <80), adjunctive calcium supplementation, no history of fractures or falls, duration longer than 6 months, cholecalciferol, and dose of 800 IU or greater. Meta-regression demonstrated no linear association between vitamin D dose or duration and treatment effect. Post hoc analysis including seven additional studies (17 total) without explicit fall definitions yielded smaller benefit (RR=0.92, 95% CI=0.87-0.98) and more heterogeneity (I(2)=36%) but found significant intergroup differences favoring adjunctive calcium over none (P=.001).

CONCLUSION:

Vitamin D treatment effectively reduces the risk of falls in older adults. Future studies should investigate whether particular populations or treatment regimens may have greater benefit.

PMID:
20579169
[PubMed - indexed for MEDLINE]
PMCID:
PMC3125705
Free PMC Article
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