Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation

Age Ageing. 2006 Sep;35(5):482-6. doi: 10.1093/ageing/afj080. Epub 2006 Apr 26.

Abstract

Objectives: To determine whether vitamin D supplementation reduces the risk of fracture or falls in elderly people in care home accommodation.

Design: A randomised controlled trial of cluster design.

Setting and subjects: 223 Residential units (mainly identical 30-bedded units), within 118 homes for elderly people throughout Britain, with 3,717 participating residents (76% women, average age 85 years). The units provided mainly or entirely residential care (35% of residents), nursing care (42%) or care for elderly mentally infirm (EMI) residents (23%).

Methods: Participants were randomly allocated by residential unit (cluster design) to a treated group offered ergocalciferol 2.5 mg every 3 months (equivalent to a daily dose of 1,100 IU), or to a control group. Fractures were reported by staff and confirmed in hospital, and routinely collected data on reported falls were obtained.

Results: After median follow-up of 10 months (interquartile range 7-14 months), 64 (3.6%) of 1,762 vitamin D-treated residents and 51 (2.6%) of 1,955 controls had one or more non-vertebral fractures, and 24 (1.3%) and 20 (1.0%), respectively, had a hip fracture. The proportion reporting at least one fall was 44% in vitamin D-treated and 43% in control residents. The differences between the vitamin D and control groups were not statistically significant. The incidence of all non-vertebral fractures in the care homes (3.2% per year) and of hip fractures (1.1% per year) was low, similar to rates in elderly people in sheltered accommodation, and the pre-treatment serum 25-hydroxy vitamin D concentration was high [median 47 nmol/l, measured in a 1% (n = 18) sample].

Conclusions: We found no evidence that vitamin D prevents fractures or falls in elderly people in care home accommodation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged, 80 and over
  • Bone Density Conservation Agents / pharmacokinetics
  • Bone Density Conservation Agents / therapeutic use*
  • Calcium / blood
  • Ergocalciferols / pharmacokinetics
  • Ergocalciferols / therapeutic use*
  • Female
  • Fractures, Bone / prevention & control*
  • Homes for the Aged
  • Humans
  • Male
  • Parathyroid Hormone / blood
  • Phosphates / blood
  • Treatment Outcome
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamins / pharmacokinetics
  • Vitamins / therapeutic use*

Substances

  • Bone Density Conservation Agents
  • Ergocalciferols
  • Parathyroid Hormone
  • Phosphates
  • Vitamins
  • Vitamin D
  • 25-hydroxyvitamin D
  • Calcium