Abstract
Preventing falls and fall-related fractures in the elderly is an objective yet to be reached. There is increasing evidence that a supplementation of vitamin D and/or of calcium may reduce the fall and fracture rates. A vitamin D-calcium supplement appears to have a high potential due to its simple application and its low cost. However, published studies have shown conflicting results as some studies failed to show any effect, while others reported a significant decrease of falls and fractures. Through a 15-year literature overview, and after a brief reminder on mechanism of falls in older adults, we reported evidences for a vitamin D action on postural adaptations - i.e., muscles and central nervous system - which may explain the decreased fall and bone fracture rates and we underlined the reasons for differences and controversies between published data. Vitamin D supplementation should thus be integrated into primary and secondary fall prevention strategies in older adults.
Highlights
Falls in the elderly are a public-health problem due to their high prevalence of 30% among subjects aged 65 and over, and their adverse outcomes [1,2,3]
Fall-related fractures are associated with excess morbidity and mortality, and substantial financial cost [1,2,3]
The intervention efficacy depends on two main principles: an interdisciplinary approach of health care professionals and a multifactorial approach in which regular physical activity has a key role [5,6]
Summary
Falls in the elderly are a public-health problem due to their high prevalence of 30% among subjects aged 65 and over, and their adverse outcomes [1,2,3]. Bischoff-Ferrari et al [23] most recently demonstrated in a 2009 meta-analysis of high-quality double-blinded randomized clinical trials - including 42279 adults aged 65 and older - the protective action of oral supplemental vitamin D against nonvertebral fractures with a dose dependant effect. This prevention was effective whether in community-dwelling or institutionalized older individuals, and was interestingly independent of additional calcium supplementation [23].
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