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Supplementation With Vitamin D Can Prevent Fractures From Falls

According to a study by the Agency for Healthcare Research and Quality (AHRQ) the number of Americans hospitalized for osteoporosis-related fractures has climbed 55% since 1995.

In an on-line Reuters Health article, Dr. Anne Elixhauser, a senior research scientist with the AHRQ said the increasing number of fractures could be from a number of factors:

  1. aging of the population, though this alone cannot account for the 55% increase
  2. lack of exercise, which helps build and preserve bone mass
  3. inadequate intake of calcium and vitamin D
  4. increased use of certain medications that can lower bone mass, such as diuretics to treat high blood pressure and proton-pump inhibitors used to treat acid reflux1

A new study published in the October 2009 issue of the British Medical Journal says that a daily supplement of vitamin D at a dose of 700-1000 IU reduces the risk of falling among older people by 19%. But a dose of less than 700 IU per day has no effect.3

Every year one in three people aged 65 and older experience at least one fall, with approximately 6 percent resulting in a fracture. The statistics are more dismal for women. Half of all women aged 50 and older will suffer an osteoporosis-related bone break in their lifetime. About one-fourth of those who fracture a hip will die within a year.2

As the senior population grows, fall prevention has become a public health concern. The British Medical Journal’s study analyzed the results of eight fall prevention trials to assess the effectiveness of vitamin D in preventing falls among older individuals (aged 65 or more). The results indicate that the benefits from supplemental vitamin D on fall prevention depended on the dose. Supplemental vitamin D2 and Vitamin D3 were investigated. 700-1000 IU supplemental vitamin D per day (vitamin D2 or vitamin D3) reduced falls by 19% and up to 26% with vitamin D3.

This effect was independent of age or additional calcium supplementation. The effect was significant within two to five months of starting treatment and extended beyond 12 months.

High dose supplemental vitamin D reduced fall risk by 19%. Supplemental vitamin D did not reduce falls at a dose of less than 700 IU per day.

The researchers concluded that to reduce the risk of falling, a daily intake of at least 700-1000 IU supplemental vitamin D is warranted in all individuals aged 65 and older, and higher doses may be even more effective.3

Another recent report analyzed the results of seven studies in which 68,500 patients aged 47-107, average age 69, took low doses of vitamin D, either alone or with calcium (1000 mg calcium carbonate), or nothing at all.

The study was presented May 27, 2009, at The European Calcified Tissue Society, which is the largest organization in Europe dedicated to promoting research in the field of bone diseases. After about 16 months, the reduction in hip fracture rates by 20% was seen in people who took vitamin D (400 IU) and calcium (1000 mg) together, regardless of age, gender and fracture history. Fracture rate in other bones was reduced by 10%.4

References

  1. Reuters Health, Norton, Amy. “Osteoporosis-linked fracture rates up dramatically” Reuters UK, Aug. 14, 2009.
  2. Agency for Healthcare Research and Quality (AHRQ) Press Release, Dec. 21, 2007.
  3. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, Wong JB, Egli A, Kiel DP, Henschkowski J. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomized controlled trials. British Medical Journal 2009 Oct 1;339:b3692. doi: 10.1136/bmj.b3692.
  4. Eiken PA, Abrahamsen B. Ugeskr Laeger. (article in Danish) 2009 Mar 9;171(11):903-6. (no abstract available.)

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