Abstract
Falls represent a significant contribution to the morbidity and mortality of the elderly population. Because vitamin D is important in bone physiology, the use of vitamin D to restore deficient bone and ameliorate the effects of bone fractures due to falls has become a common practice in recent years. Following introduction of widespread use, reports began to emerge that vitamin D not only aided in repair of fall-induced bone fractures, but that it also reduced the occurrence of falls. Vitamin D now has become a routine intervention as a fall-prevention measure. Early analyses found evidence of prevention efficacy (reduced falls), but recent analyses are more equivocal. We retrospectively examined the records of 350 patients in a long-term care facility in which vitamin D administration and the number of falls were recorded as part of a comprehensive database of care. We found a dramatic rise in vitamin D use over the period covered (2006 – 2011) and a corresponding dramatic decrease in the number of falls. However, the number of falls continued to decline after 2008, despite a plateau in number of patients on vitamin D, particularly females. It appears that other factors contribute to the overall decline.
Highlights
Already by 1987 strategies to address the morbidity and mortality associated with falls in the elderly and others in which osteoporosis is common advocated optimization of calcium absorption, a process in which vitamin D plays an important role [1]
Because vitamin D is important in bone physiology, the use of vitamin D to restore deficient bone and ameliorate the effects of bone fractures due to falls has become a common practice in recent years
Following introduction of widespread use, reports began to emerge that vitamin D aided in repair of fall-induced bone fractures, but that it reduced the occurrence of falls
Summary
Already by 1987 strategies to address the morbidity and mortality associated with falls in the elderly and others in which osteoporosis is common (such as postmenopausal women) advocated optimization of calcium absorption, a process in which vitamin D plays an important role [1]. An insufficient amount of vitamin D (calcium) leads to osteoporosis and bone brittleness that predisposes the individual to bone fractures during falls [4]. Since few foods contain significant amounts of vitamin D, the diet is not usually a major source (unless fortified with the vitamin). An exposure to sunshine, which promotes endogenous synthesis of vitamin D from cholesterol [5], is important. Situations that tend to limit exposure to the sun, increase the likelihood that vitamin D levels can drop below optimal levels [6]
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