Exercise, Vitamin D, and Falls | Journal Scan

Mar 24, 2015
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Authors:
Uusi-Rasi K, Patil R, Karinkanta S, et al.
Citation:
Exercise and Vitamin D in Fall Prevention Among Older Women: A Randomized Clinical Trial. JAMA Intern Med 2015;Mar 23:[Epub ahead of print].
Summary By:
Elizabeth A. Jackson, MD, FACC

Study Questions:

Does vitamin D with or without exercise reduce the risk for falls in elderly women?

Methods:

This was a randomized, double-blind, placebo-controlled trial examining vitamin D supplementation (800 IU/d) with or without exercise, conducted between April 2010 and March 2013 in Tampere, Finland. Participants were home-dwelling women, ages 70-80 years, who had a history of at least one prior fall over the year prior to entry. Prior to entry, women could not have used vitamin D supplements or have any contraindication to exercise. The study was conducted over a 2-year follow-up period for each participant. The four groups included women randomized to exercise alone, vitamin D alone, exercise with vitamin D, or control. The primary outcome of interest was reported falls. Secondary outcomes included bone density and physical functioning (including muscle strength, balance, and mobility).

Results:

A total of 409 women were randomized to one of the four groups. Vitamin D did not reduce the number of falls reported. Nor did exercise reduce the number of falls reported. Fall rates per 100 person-years were 118.2 (control group), 132.1 (vitamin D alone), 120.7 (exercise alone), and 113.1 (vitamin D and exercise). However, exercise was observed to be associated with reduced injury related to falls. Hazard ratios for injury-related falls was lower in the exercise groups (0.38; 95% confidence interval, 0.17-0.83 for exercise with vitamin D) and (0.47; 95% confidence interval, 0.23-0.99 without vitamin D). Vitamin D was associated with improved maintenance of femoral neck bone mineral density and increased tibial trabecular density.

Conclusions:

The investigators concluded that exercise, which improved strength and balance, was associated with reduced injuries related to falls among elderly women. Exercise also improved physical functioning.

Perspective:

These data suggest that while vitamin D may provide some benefit related to bone health, vitamin D alone will not reduce the risk for injurious falls.

Keywords: Exercise, Vitamin D, Accidental Falls, Female, Aged, Primary Prevention, Bone Density, Muscle Strength, Femoral Neck Fractures, Control Groups, Double-Blind Method, Follow-Up Studies, Geriatrics


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