Falls are one of the most common accidents that can happen at home for people at any age, but the consequences can vary. For me, last winter, I fell on some ice, causing a serious injury from which I am still recovering. For elderly people, who are at an increased risk of falling, the consequences can be even more serious. Now, with more elderly folks maintaining their independence for longer and residing in their homes until a later age, the likelihood that a fall can occur is much more realistic.
Falls are a problem because they account for most of the fracture risk associated with the aging process. If a senior citizen fractures their hip from a fall, this can result in a major hospitalization and a lengthy recovery period.
As previous evidence has revealed, vitamin D, with or without calcium supplementation, may be able to prevent falls in the elderly. While the evidence was contradictory in nature, some new research has indicated just how the use of vitamin D relates to fracture risk from falls—or rather, how it doesn’t.
Researchers analyzed the results from 20 controlled trials that assessed the relationship between the use of vitamin D with or without calcium and the risk of falls in approximately 30,000 elderly subjects.
The analysis indicated that there was no relationship between the use of vitamin D and the risk of falling in this susceptible population. As the authors of this study state, “Future trials with similar designs are unlikely to alter these conclusions. At present, there is little justification for prescribing vitamin D supplements to prevent falls.”
My question: why would there be an expected benefit from using vitamin D for the purposes of reducing the risk of falling in an elderly person? The answer: I would expect no such benefit.
If you look at why elderly people fall, it has nothing to do with the levels of vitamin D in their bloodstream. Elderly people fall because they can trip or stumble very easily. Tripping on mats or slipping on a slick surface has to be prevented. They may even lose their balance because of medication use. In my opinion, the elderly are chronically overmedicated, and this could account for their increased risk of falling.
One of the most common reasons why the elderly are more susceptible to falls and fractures is because they are frail. As they age, they lose muscle tissue, not just bone substance, and this prevents them from standing, walking, and maneuvering around their homes. This process is known as sarcopenia, and it accounts for one of the most common causes of falls leading to fractures. As many of these folks may also have osteoporosis, it becomes clear as to why this can happen so easily.
Using vitamin D for the purposes of preventing falls is bound to produce these types of research results and cause continued confusion regarding the proper use of vitamin D in clinical medicine. The most effective way to prevent sarcopenia is through exercise and appropriate changes to the diet.
Sources for Today’s Article:
Laidman, J., “Vitamin D No Help in Fall Risk, Large Meta-Analysis Shows,” Medscape web site, April 24, 2014; http://www.medscape.com/viewarticle/824070.
Bolland, M.J., et al., “Vitamin D supplementation and falls: a trial sequential meta-analysis,” The Lancet Diabetes & Endocrinology April 24, 2014; doi:10.1016/S2213-8587(14)70068-3.