Vitamin D Supplementation to Prevent Falls in the Elderly: Evidence and Practical Considerations

@article{Fosnight2008VitaminDS,
  title={Vitamin D Supplementation to Prevent Falls in the Elderly: Evidence and Practical Considerations},
  author={Susan M. Fosnight and William J Zafirau and Susan E Hazelett},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
  year={2008},
  volume={28}
}
Pharmacists in both ambulatory and institutional settings are often in a position to help optimize the drug regimens of patients who are experiencing falls. Supplementation with vitamin D is an important emerging therapy for the prevention of falls. Numerous investigators have recently studied or reviewed the association between vitamin D supplementation and decreased risk of falls in elderly patients, yet little of this information is available in the pharmacy literature. A MEDLINE search was… 
Association Between Vitamin D Dosing Regimen and Fall Prevention in Long-term Care Seniors
TLDR
Daily standard dosage of vitamin D has greater benefits in reducing fall rate than that of intermittent supratherapeutic doses, but not in number of fallers, which could imply that vitamin D is useful in preventing fall recurrence rather than first fall.
Effect of Monthly 100,000 IU Vitamin D Supplementation on Falls and Non-Vertebral Fractures
TLDR
Vitamin D supplementation had no beneficial effect on the reduction of falls and non-vertebral fractures in elderly patients and further multi-center studies of longer duration are required to prove the favorable effects of vitamin D supplements.
Vitamin D deficiency: appropriate replenishment therapies and the effects of vitamin D toxicity.
TLDR
While many older patients can be expected to have vitamin D deficiencies, pharmacists should be aware of appropriate replenishment therapies and correct dosing of different vitamin D products, particularly as public awareness of benefits continues to increase.
Diagnosis and management of osteoporosis in the older senior
TLDR
Current osteoporosis therapies appear safe and efficacious in the older senior and most will live long enough to derive a benefit from these therapies, and further studies are needed in older seniors, especially men.
Vitamin D status and peripheral arterial disease: evidence so far
TLDR
It is shown that vitamin D deficiency could be an independent risk factor for the development of PAD and that this risk factor is easily correctable.
Correction of vitamin D deficiency in critically ill patients - VITdAL@ICU study protocol of a double-blind, placebo-controlled randomized clinical trial
TLDR
This study compares high-dose oral cholecalciferol (vitamin D3) versus placebo treatment in a mixed population of 480 critically ill patients with low 25-hydroxyvitamin-D levels with the primary endpoint being length of hospital stay.
Correction of vitamin D deficiency in critically ill patients: a randomized, double-blind, placebo-controlled trial ("VITDAL@ICU")
TLDR
No clinical trial has prospectively evaluated clinical outcomes in patients treated with vitamin D in an intensive care setting, but treatment with sufficiently high doses of vitamin D may represent a promising and inexpensive intervention option.
Vitamin D and Calcium: A Systematic Review of Health Outcomes (Update).
TLDR
The current report identified one new systematic review published since the original report that addressed whether a dose response relationship exists between dietary and supplemental vitamin D intake and serum 25(OH)D concentrations.
Vitamin D supplementation to reduce the risk of falls and fractures: the dosing dilemma.
Several trials have been performed to assess the potential benefits of vitamin D on musculoskeletal health. Most, but not all, have revealed that vitamin D supplementation improves strength and
Preventing falls in older people.
  • S. Conroy
  • Medicine
    Nursing standard (Royal College of Nursing (Great Britain) : 1987)
  • 2015
TLDR
There is insufficient evidence for health care commissioners to recommend screening and intervention for falls, and work on testing falls prevention interventions for acceptability is required, followed by a further adequately powered RCT to determine the clinical effectiveness of a systematic screening programme and intervention.
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References

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TLDR
Two main factors discussed in this review may help public health efforts to ensure desirable vitamin D levels for fall and fracture prevention, including a sufficient dose of vitamin D and improved adherence to supplementation.
Effect of Vitamin D on falls: a meta-analysis.
TLDR
Vitamin D supplementation appears to reduce the risk of falls among ambulatory or institutionalized older individuals with stable health by more than 20%.
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TLDR
It is found that vitamin D prevents fractures or falls in elderly people in care home accommodation, and the pre-treatment serum 25-hydroxy vitamin D concentration was high.
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TLDR
The prevalence of vitamin D insufficiency is high in a falls clinic population and it is difficult to predict which individuals are most at risk within this population, so in the absence of toxic effects, a pragmatic approach may be to supplement all attendees at a falls clinics.
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TLDR
It seems that 800 IU (20 µg) vitamin D per day in combination with calcium reduces systolic blood pressure in elderly women, and a combination of fortification and individual supplementation is proposed.
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  • Medicine
    Mayo Clinic proceedings
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TLDR
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TLDR
There is a trend towards a reduction in the risk of fall among patients treated with vitamin D(3) alone compared with placebo, suggesting that vitamin D (3) should be an integral part of effective osteoporosis management.
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TLDR
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TLDR
From experimental studies it was found that vitamin D metabolites directly influence muscle cell maturation and functioning through a vitamin D receptor, and vitamin D supplementation in vitamin D-deficient, elderly people improved muscle strength, walking distance, and functional ability and resulted in a reduction in falls and non-vertebral fractures.
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