Does vitamin D stop inpatients falling? A randomised controlled trial

被引:56
作者
Burleigh, Elizabeth
Mccoll, John
Potter, Jan
机构
[1] Victoria Infirm, Mansionhouse Unit, Dept Med, Glasgow G41 3DX, Lanark, Scotland
[2] Univ Glasgow, Dept Math, Glasgow G12 8QQ, Lanark, Scotland
[3] Univ Wollongong, S Eastern Sydney & Allawara Area Hlth Serv, Sydney, NSW 2052, Australia
关键词
vitamin D; accidental falls; elderly; hospitalisation; randomised controlled trial;
D O I
10.1093/ageing/afm087
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 [法学]; 0303 [社会学]; 100203 [老年医学];
摘要
Background vitamin D deficiency is common in older people and may increase risk of falls and fracture. Hospital inpatients are at particular risk of falling. Previous studies suggest that vitamin D improves neuromuscular function and reduces falls. Objective to determine whether routine supplementation with vitamin D plus calcium reduces numbers of fallers and falls in a cohort of hospital admissions while they are inpatients. Design randomised, double-blind, controlled study. Participants two hundred and five acute admissions > 65 years to a geriatric medical unit. Methods patients were randomised to intervention of daily vitamin D 800 iu plus calcium 1,200 mg or control group of daily calcium 1,200 mg, until discharge or death. Results baseline characteristics were similar in both groups with a median age 84 years and a median length of stay = 30 days (IQR 14.75-71.00). In a pre-selected sub-group (54/205 participants), median admission vitamin D level = 22.00 nmol/l (IQR 15.00-30.50). This did not significantly increase in the treatment versus control group. Median study drug adherence = 88%, with no significant difference between study groups (Mann-Whitney: P = 0.711). Although there were fewer fallers in the vitamin D cohort, this did not reach statistical significance (vitamin D: calcium = 36: 45 fallers; RR 0.82 (CI 0.59-1.16). Neither the mean number of falls (vitamin D: calcium = 1.040: 1.155; Mann-Whitney P = 0.435) or time to first fall (Log-rank test P = 0.377) differed between groups. Conclusions in a population of geriatric hospital inpatients, vitamin D did not reduce the number of fallers. Routine supplementation cannot be recommended to reduce falls in this group.
引用
收藏
页码:507 / 513
页数:8
相关论文
共 29 条
[1]
[Anonymous], CLIN PRACT GUID ASS
[2]
[Anonymous], 2001, J AM GERIATR SOC, V49, P664, DOI DOI 10.1046/J.1532-5415.2001.49115.X
[3]
Effects of vitamin D and calcium supplementation on falls:: A randomized controlled trial [J].
Bischoff, HA ;
Stähelin, HB ;
Dick, W ;
Akos, R ;
Knecht, M ;
Salis, C ;
Nebiker, M ;
Theiler, R ;
Pfeifer, M ;
Begerow, B ;
Lew, RA ;
Conzelmann, M .
JOURNAL OF BONE AND MINERAL RESEARCH, 2003, 18 (02) :343-351
[4]
Muscle strength in the elderly: Its relation to vitamin D metabolites [J].
Bischoff, HA ;
Stahelin, HB ;
Urscheler, N ;
Ehrsam, R ;
Vonthein, R ;
Perrig-Chiello, P ;
Tyndall, A ;
Theiler, R .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1999, 80 (01) :54-58
[5]
Effect of vitamin D on falls - A meta-analysis [J].
Bischoff-Ferrari, HA ;
Dawson-Hughes, B ;
Willett, WC ;
Staehelin, HB ;
Bazemore, MG ;
Zee, RY ;
Wong, JB .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (16) :1999-2006
[6]
Burleigh E, 2006, SCOT MED J, V51, P27
[7]
1,25-DIHYDROXYVITAMIN-D3 RECEPTORS AND HORMONAL RESPONSES IN CLONED HUMAN SKELETAL-MUSCLE CELLS [J].
COSTA, EM ;
BLAU, HM ;
FELDMAN, D .
ENDOCRINOLOGY, 1986, 119 (05) :2214-2220
[8]
Vitamin D supplementation improves neuromuscular function in older people who fall [J].
Dhesi, JK ;
Jackson, SHD ;
Bearne, LM ;
Moniz, C ;
Hurley, MV ;
Swift, CG ;
Allain, TJ .
AGE AND AGEING, 2004, 33 (06) :589-595
[9]
A rationale for vitamin D prescribing in a falls clinic population [J].
Dhesi, JK ;
Moniz, C ;
Close, JCT ;
Jackson, SHD ;
Allain, TJ .
AGE AND AGEING, 2002, 31 (04) :267-271
[10]
Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 mg daily [J].
Dukas, L ;
Bischoff, HA ;
Lindpaintner, LS ;
Schacht, E ;
Birkner-Binder, D ;
Damm, TN ;
Thalmann, B ;
Stähelin, HB .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (02) :230-236