The Effects of Exercise and Vitamin D in Fall Prevention Among Older Women

Neither exercise nor vitamin D affected the rate of falls in elderly women, according to a study published March 23 in JAMA: Internal Medicine. However, exercise was shown to reduce the number of falls requiring medical attention.

In a two year, double-blind, placebo-controlled trial, researchers examined the effects of vitamin D supplementation and targeted exercise training between April 2010 and March 2013 in 409 home-dwelling women 70 to 80 years old. Participants were eligible for the trial if they had at least one fall during the previous year, did not take vitamin D supplements, and had no contraindication to exercise. The 409 participants were randomly assigned to four study groups: placebo without exercise; vitamin D (800 IU/d) without exercise; placebo and exercise; and vitamin D (800 IU/d) and exercise. Researchers instructed the participants to record the number of falls per month in a diary, along with any falls that caused injury needing medical attention.

The results of the study showed that while vitamin D maintained femoral neck bone density and increased tibial trabecular density slightly, the supplement did not reduce the number of falls participants reported. Similarly, exercise did not reduce the number of falls, but the training did cut the amount of injurious falls by more than half.

"Apparently, this effect [of exercise on the number of injurious falls] was attributable to improved physical functioning," explained Kirsti Uusi-Rasi, PhD, et al. "Muscle strength and balance training has been shown to prevent falls in community-dwelling older adults, and recent meta-analyses have confirmed that such exercise programs are effective in preventing fall-induced injuries."

"This trial reminds us that although vitamin D is known as the sunshine vitamin and higher levels are associated with better health in observational studies, more research is needed to understand the effectiveness of vitamin D supplementation on clinical outcomes," said Erin S. LeBlanc, MD, MPH, and Roger Chou, MD, in an accompanying editorial comment. "In particular, this trial (like many before it) was performed among white European women and may not apply to diverse U.S. population."

Clinical Topics: Prevention, Nonstatins, Diet

Keywords: Accidental Falls, Bone Density, Dietary Supplements, Double-Blind Method, Longitudinal Studies, Muscle Strength, Research, Sunlight, Vitamin D, Vitamins

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