A higher dose of vitamin d reduces the risk of falls in nursing home residents: A randomized, multiple-dose study

被引:283
作者
Broe, Kerry E.
Chen, Tai C.
Weinberg, Janice
Bischoff-Ferrari, Heike A.
Holick, Michael F.
Kiel, Douglas P.
机构
[1] Inst Aging Res, Boston, MA 02131 USA
[2] Boston Univ, Med Ctr, Dept Med, Vitamin D Lab, Boston, MA 02215 USA
[3] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02215 USA
[4] Univ Zurich Hosp, Dept Rheumatol, CH-8091 Zurich, Switzerland
[5] Univ Zurich Hosp, Inst Phys Med & Rehabil, CH-8091 Zurich, Switzerland
[6] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
[7] Harvard Univ, Sch Med, Div Aging, Boston, MA 02115 USA
关键词
vitamin D; falls; nursing home; randomized clinical trial;
D O I
10.1111/j.1532-5415.2007.01048.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
OBJECTIVES: To determine the effect of four vitamin D supplement doses on falls risk in elderly nursing home residents. DESIGN: Secondary data analysis of a previously conducted randomized clinical trial. SETTING: Seven hundred twenty-five-bed long-term care facility. PARTICIPANTS: One hundred twenty-four nursing home residents (average age 89). INTERVENTION: Participants were randomly assigned to receive one of four vitamin D supplement doses (200 IU, 400 IU, 600 IU, or 800 IU) or placebo daily for 5 months. MEASUREMENTS: Number of fallers and number of falls assessed using facility incident tracking database. RESULTS: Over the 5-month study period, the proportion of participants with falls was 44% in the placebo group (11/25), 58% (15/26) in the 200 IU group, 60% (15/25) in the 400 IU group, 60% (15/25) in the 600 IU group, and 20% (5/23) in the 800 IU group. Participants in the 800 IU group had a 72% lower adjusted-incidence rate ratio of falls than those taking placebo over the 5 months (rate ratio=0.28; 95% confidence interval=0.11-0.75). No significant differences were observed for the adjusted fall rates compared to placebo in any of the other supplement groups. CONCLUSION: Nursing home residents in the highest vitamin D group (800 IU) had a lower number of fallers and a lower incidence rate of falls over 5 months than those taking lower doses. Adequate vitamin D supplementation in elderly nursing home residents could reduce the number of falls experienced by this high falls risk group.
引用
收藏
页码:234 / 239
页数:6
相关论文
共 32 条
  • [1] Vitamin D2 is much less effective than vitamin D3 in humans
    Armas, LAG
    Hollis, BW
    Heaney, RP
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2004, 89 (11) : 5387 - 5391
  • [2] Effects of vitamin D and calcium supplementation on falls:: A randomized controlled trial
    Bischoff, HA
    Stähelin, HB
    Dick, W
    Akos, R
    Knecht, M
    Salis, C
    Nebiker, M
    Theiler, R
    Pfeifer, M
    Begerow, B
    Lew, RA
    Conzelmann, M
    [J]. JOURNAL OF BONE AND MINERAL RESEARCH, 2003, 18 (02) : 343 - 351
  • [3] Bischoff-Ferrari HA, 2004, AM J CLIN NUTR, V80, P752
  • [4] Effect of vitamin D on falls - A meta-analysis
    Bischoff-Ferrari, HA
    Dawson-Hughes, B
    Willett, WC
    Staehelin, HB
    Bazemore, MG
    Zee, RY
    Wong, JB
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (16): : 1999 - 2006
  • [5] Fracture prevention with vitamin D supplementation - A meta-analysis of randomized controlled trials
    Bischoff-Ferrari, HA
    Willett, WC
    Wong, JB
    Giovannucci, E
    Dietrich, T
    Dawson-Hughes, B
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (18): : 2257 - 2264
  • [6] AN EPIDEMIOLOGIC-STUDY OF FALL-RELATED FRACTURES AMONG INSTITUTIONALIZED OLDER-PEOPLE
    CALI, CM
    KIEL, DP
    [J]. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1995, 43 (12) : 1336 - 1340
  • [7] VITAMIN-D(3) AND CALCIUM TO PREVENT HIP-FRACTURES IN ELDERLY WOMEN
    CHAPUY, MC
    ARLOT, ME
    DUBOEUF, F
    BRUN, J
    CROUZET, B
    ARNAUD, S
    DELMAS, PD
    MEUNIER, PJ
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (23) : 1637 - 1642
  • [8] METHODS FOR THE DETERMINATION OF THE CIRCULATING CONCENTRATION OF 25-HYDROXYVITAMIN-D
    CHEN, TC
    TURNER, AK
    HOLICK, MF
    [J]. JOURNAL OF NUTRITIONAL BIOCHEMISTRY, 1990, 1 (06) : 315 - 319
  • [9] A METHOD FOR THE DETERMINATION OF THE CIRCULATING CONCENTRATION OF VITAMIN-D
    CHEN, TC
    TURNER, AK
    HOLICK, MF
    [J]. JOURNAL OF NUTRITIONAL BIOCHEMISTRY, 1990, 1 (05) : 272 - 276
  • [10] Estimates of optimal vitamin D status
    Dawson-Hughes, B
    Heaney, RP
    Holick, MF
    Lips, P
    Meunier, PJ
    Vieth, R
    [J]. OSTEOPOROSIS INTERNATIONAL, 2005, 16 (07) : 713 - 716