Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals

• Published in: Osteoporosis international Vol. 20; no. 2; pp. 315 - 322
• Main Authors: Pfeifer, M., Begerow, B., Minne, H. W., Suppan, K., Fahrleitner-Pammer, A., Dobnig, H.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01.02.2009; Springer; Springer Nature B.V
• Subjects: Accidental Falls; Accidental Falls - prevention & control; administration & dosage; Aged; Aged, 80 and over; Austria; Biological and medical sciences; Calcium; Calcium - administration & dosage; Dietary supplements; Diseases of the digestive system; Diseases of the osteoarticular system; Double-Blind Method; Drug Therapy, Combination; elderly; Endocrinology; Falls; Female; Follow-Up Studies; Fractures, Bone; Fractures, Bone - prevention & control; Germany; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Muscles; Muscles - physiology; Muscular system; Older people; Original Article; Orthopedics; Osteoporosis. Osteomalacia. Paget disease; physiology; prevention & control; Proportional Hazards Models; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rheumatology; Social Environment; Statistics, Nonparametric; Time Factors; Treatment Outcome; Vitamin D; Vitamin D - administration & dosage; Austria; Germany; Falls; Muscle function; Vitamin D; Elderly; Calcium supplementation; Human; Calcium; Diseases of the osteoarticular system; Rheumatology; Long term; Osteoporosis; Diet therapy; Fall; Supplementation
• DOI: 10.1007/s00198-008-0662-7
• ISSN: 0937-941X; 1433-2965

Summary In 242 community-dwelling seniors, supplementation with either 1000 mg of calcium or 1000 mg of calcium plus vitamin D resulted in a decrease in the number of subjects with first falls of 27% at month 12 and 39% at month 20. Additionally, parameters of muscle function improved significantly. Introduction The efficacy of vitamin D and calcium supplementation on risk of falling in the elderly is discussed controversially. Randomized controlled trials using falls as primary outcome are needed. We investigated long-term effects of calcium and vitamin D on falls and parameters of muscle function in community-dwelling elderly women and men. Methods Our study population consisted of 242 individuals recruited by advertisements and mailing lists (mean [ ± SD] age, 77 ± 4 years). All serum 25-hydroxyvitamin D (25[OH]D) levels were below 78 nmol/l. Individuals received in a double blinded fashion either 1000 mg of calcium or 1000 mg of calcium plus 800 IU of vitamin D per day over a treatment period of 12 months, which was followed by a treatment-free but still blinded observation period of 8 months. Falls were documented using diaries. The study took place in Bad Pyrmont, Germany (latitude 52°) and Graz, Austria (latitude 46°). Results Compared to calcium mono, supplementation with calcium plus vitamin D resulted in a significant decrease in the number of subjects with first falls of 27% at month 12 (RR = 0.73; CI = 0.54–0.96) and 39% at month 20 (RR = 0.61; CI = 0.34–0.76). Concerning secondary endpoints, we observed significant improvements in quadriceps strength of 8%, a decrease in body sway of 28%, and a decrease in time needed to perform the TUG test of 11%. Discussion Combined calcium and vitamin D supplementation proved superior to calcium alone in reducing the number of falls and improving muscle function in community-dwelling older individuals.