Exercise, Vitamin D, and Falls | Journal Scan

Study Questions:

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


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).


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.


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.


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.

Clinical Topics: Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Prevention, Exercise

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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