The effect of vitamin D and calcium supplementation on falls in older adults

A systematic review and meta-analysis

Einfluss der Vitamin-D- und Kalziumsupplementierung auf Stürze bei älteren Erwachsenen

Eine systematische Übersicht und Metaanalyse

Abstract

Objectives

A number of studies have hypothesized that vitamin D is a potential factor in the prevention of falls in the elderly; however, the effect of vitamin D is still inconsistent and not quantitative. We conducted this meta-analysis to assess the effect of vitamin D on falls among elderly individuals.

Methods

The PubMed and Cochrane Library databases were searched from the earliest possible year up to December 2016. Two authors working independently reviewed the trials, and odds ratios (ORs) were calculated using a fixed-effect or random-effect model by Review Manager 5.3. We included only double-blind randomized, controlled trials (RCTs) of vitamin D in elderly populations that examined fall results.

Results

A total of 26 articles were included in which 16,540 elderly individuals received vitamin D supplementation, while 16,146 were assigned to control groups. The meta-analysis showed that combined vitamin D plus calcium supplementation has a significant effect on the reduction in the risk of falls (OR for the risk of suffering at least one fall, 0.87; 95% CI, 0.80–0.94). However, no significant association between vitamin D2 or D3 and a reduction in the risk of falls was found (OR, 0.77; 95% CI, 0.58–1.03 for vitamin D2, and OR, 1.08; 95% CI, 0.98–1.20 for vitamin D3).

Conclusions

Combined calcium plus vitamin D supplementation is statistically significantly associated with a reduction in fall risks across various populations.

Zusammenfassung

Zielsetzung

In zahlreichen Studien wurde spekuliert, dass Vitamin D ein potenzieller Faktor in der Sturzprävention bei älteren Menschen ist. Der Effekt ist jedoch weiterhin widersprüchlich und nicht quantifiziert. In der vorliegenden Metaanalyse haben wir den Einfluss von Vitamin D auf Stürze bei älteren Menschen untersucht.

Methoden

Die Datenbanken PubMed und Cochrane Library wurden vom frühesten erfassten Jahr bis Dezember 2016 durchsucht. Zwei Autoren sichteten unabhängig die Studien. Unter Anwendung von Review Manager 5.3 wurden mit einem Fixed-effects- oder Random-effects-Modell Odds Ratios (OR) berechnet. Einschluss in die Analyse fanden nur doppelblinde, randomisierte, kontrollierte Studien (RCT), in denen Vitamin D in Populationen älterer Menschen eingesetzt und Sturzergebnisse ausgewertet wurden.

Ergebnisse

Insgesamt wurden 26 Beiträge eingeschlossen, in denen 16.540 ältere Menschen eine Vitamin-D-Supplementierung erhielten und 16.146 Personen Kontrollgruppen zugeteilt waren. Wie die Metaanalyse ergab, hat die kombinierte Vitamin-D- und Kalziumsupplementierung einen signifikanten Effekt auf die Reduktion des Sturzrisikos (OR für das Risiko, mindestens einen Sturz zu erleiden 0,87; 95%-Konfidenzintervall [KI] 0,80–0,94). Dagegen fand sich keine signifikante Assoziation zwischen Vitamin D2 oder D3 und einer Reduktion des Sturzrisikos (für Vitamin D2: OR 0,77; 95%-KI 0,58–1,03; für Vitamin D3: OR 1,08; 95%-KI 0,98–1,20).

Schlussfolgerungen

Die kombinierte Vitamin-D- und Kalziumsupplementierung ist über verschiedene Populationen hinweg statistisch signifikant mit einer Reduktion des Sturzrisikos assoziiert.

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Abbreviations

RCT:

Randomized controlled trial

OD:

Odds ratio

CI:

Confidence interval

MD:

Mean deviation

VD2:

Vitamin D2

VD3:

Vitamin D3

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Funding

Key program of Clinical Specialty Disciplines of Ningbo (2013-88), Hua-Mei foundation (2017HMKY17)

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Correspondence to Prof. Qingjiang Pang.

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H. Wu and Q. Pang declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Wu, H., Pang, Q. The effect of vitamin D and calcium supplementation on falls in older adults . Orthopäde 46, 729–736 (2017). https://doi.org/10.1007/s00132-017-3446-y

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Keywords

  • Vitamin D
  • Calcium
  • 25-Hydroxyvitamin D
  • 1, 25-Dihydroxyvitamin D
  • Fall risk
  • Elderly

Schlüsselwörter

  • Vitamin D
  • Kalzium
  • 25-Hydroxyvitamin D
  • 1,25-Dihydroxyvitamin D
  • Sturzrisiko
  • Ältere Menschen