A Higher Dose of Vitamin D Reduces the Risk of Falls in Nursing Home Residents: A Randomized, Multiple-Dose Study

Authors

  • Kerry E. Broe MPH,

    1. From the *Institute for Aging Research, Hebrew SeniorLife, Boston, MassachusettsVitamin D Laboratory, Department of Medicine, Boston Medical Center, Boston, MassachusettsDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts§Department of Rheumatology and Institute of Physical Medicine and Rehabilitation, University Hospital Zurich, Zurich, Switzerland, Department of Nutrition, Harvard School of Public Health, Boston, MassachusettsDivision on Aging, Harvard Medical School, Boston, Massachusetts.
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  • Tai C. Chen PhD,

    1. From the *Institute for Aging Research, Hebrew SeniorLife, Boston, MassachusettsVitamin D Laboratory, Department of Medicine, Boston Medical Center, Boston, MassachusettsDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts§Department of Rheumatology and Institute of Physical Medicine and Rehabilitation, University Hospital Zurich, Zurich, Switzerland, Department of Nutrition, Harvard School of Public Health, Boston, MassachusettsDivision on Aging, Harvard Medical School, Boston, Massachusetts.
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  • Janice Weinberg ScD,

    1. From the *Institute for Aging Research, Hebrew SeniorLife, Boston, MassachusettsVitamin D Laboratory, Department of Medicine, Boston Medical Center, Boston, MassachusettsDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts§Department of Rheumatology and Institute of Physical Medicine and Rehabilitation, University Hospital Zurich, Zurich, Switzerland, Department of Nutrition, Harvard School of Public Health, Boston, MassachusettsDivision on Aging, Harvard Medical School, Boston, Massachusetts.
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  • Heike A. Bischoff-Ferrari MD, MPH,

    1. From the *Institute for Aging Research, Hebrew SeniorLife, Boston, MassachusettsVitamin D Laboratory, Department of Medicine, Boston Medical Center, Boston, MassachusettsDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts§Department of Rheumatology and Institute of Physical Medicine and Rehabilitation, University Hospital Zurich, Zurich, Switzerland, Department of Nutrition, Harvard School of Public Health, Boston, MassachusettsDivision on Aging, Harvard Medical School, Boston, Massachusetts.
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  • Michael F. Holick MD, PhD,

    1. From the *Institute for Aging Research, Hebrew SeniorLife, Boston, MassachusettsVitamin D Laboratory, Department of Medicine, Boston Medical Center, Boston, MassachusettsDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts§Department of Rheumatology and Institute of Physical Medicine and Rehabilitation, University Hospital Zurich, Zurich, Switzerland, Department of Nutrition, Harvard School of Public Health, Boston, MassachusettsDivision on Aging, Harvard Medical School, Boston, Massachusetts.
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  • Douglas P. Kiel MD, MPH

    1. From the *Institute for Aging Research, Hebrew SeniorLife, Boston, MassachusettsVitamin D Laboratory, Department of Medicine, Boston Medical Center, Boston, MassachusettsDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts§Department of Rheumatology and Institute of Physical Medicine and Rehabilitation, University Hospital Zurich, Zurich, Switzerland, Department of Nutrition, Harvard School of Public Health, Boston, MassachusettsDivision on Aging, Harvard Medical School, Boston, Massachusetts.
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Address correspondence to Kerry E. Broe, Institute for Aging Research, Hebrew SeniorLife, 1200 Center Street, Roslindale, MA 02131. E-mail: broe@hrca.harvard.edu

Abstract

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.

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