Does vitamin D stop inpatients falling? A randomised controlled trial.
What this study found
Vitamin D plus calcium did not reduce falls in this geriatric inpatient population. The number of fallers was 36/100 in the intervention group versus 45 in control, with RR 0.82 (95% CI 0.59 to 1.16; P = 0.263); mean falls were 1.040 versus 1.155 (P = 0.435). Time to first fall was also not different (P = 0.377), and fractures were rare with no significant difference (1 vs control, P = 0.327). The authors concluded that routine vitamin D plus calcium supplementation cannot be recommended to prevent falls in this setting.
- Study & population
- Randomized controlled trial in acutely admitted geriatric inpatients aged >65 years in a geriatric medical unit in Scotland, UK.
- Intervention
- Oral cholecalciferol 800 IU plus calcium carbonate 1,200 mg once daily, continued until hospital discharge or death.
- Key limitation
- Single inpatient-unit trial with a relatively small sample and variable hospital length of stay, which limits power and generalizability.
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Open PDFOriginal abstract
BACKGROUND Vitamin D deficiency is common in older people and may increase risk of falls and fracture. Hospital inpatients are at particular risk of falling. Previous studies suggest that vitamin D improves neuromuscular function and reduces falls. OBJECTIVE To determine whether routine supplementation with vitamin D plus calcium reduces numbers of fallers and falls in a cohort of hospital admissions while they are inpatients. DESIGN Randomised, double-blind, controlled study. PARTICIPANTS two hundred and five acute admissions >65 years to a geriatric medical unit. METHODS Patients were randomised to intervention of daily vitamin D 800 iu plus calcium 1,200 mg or control group of daily calcium 1,200 mg, until discharge or death. RESULTS Baseline characteristics were similar in both groups with a median age 84 years and a median length of stay = 30 days (IQR 14.75-71.00). In a pre-selected sub-group (54/205 participants), median admission vitamin D level = 22.00 nmol/l (IQR 15.00-30.50). This did not significantly increase in the treatment versus control group. Median study drug adherence = 88%, with no significant difference between study groups (Mann-Whitney: P = 0.711). Although there were fewer fallers in the vitamin D cohort, this did not reach statistical significance (vitamin D: calcium = 36:45 fallers; RR 0.82 (CI 0.59-1.16). Neither the mean number of falls (vitamin D: calcium = 1.040:1.155; Mann-Whitney P = 0.435) or time to first fall (Log-rank test P = 0.377) differed between groups. CONCLUSIONS In a population of geriatric hospital inpatients, vitamin D did not reduce the number of fallers. Routine supplementation cannot be recommended to reduce falls in this group.