Every year falls affect approximately
one in three older adults living at home, with approximately one in 10 falls resulting
in serious injury. Even if an injury does not occur, the fear of falling can
lead to reduced activity and a loss of independence.
Research has shown that vitamin D plays a key role in
maintaining muscle integrity and strength and some studies suggest vitamin D may reduce the risk of falls.
Homebound elderly, a generally
vulnerable population due to poor dietary intake and nutrition-related
health conditions as well as decreased exposure to sunlight, are at increased
risk for low vitamin D levels, possibly leading to more falls.
Researchers at Wake Forest Baptist Medical Center set out
to evaluate the feasibility of delivering a vitamin D supplement through a
Meals-on-Wheels (MOW) program to improve the clients’ vitamin D levels and
The study is published in the early online edition (8/16/2015)
of the Journal of the American Geriatrics Society.
“Falls in homebound older people often lead to disability
and placement in a nursing home,” said Denise Houston, Ph.D., R.D., associate
professor of gerontology and geriatric medicine at Wake Forest Baptist and lead
author of the study. “One or our aging center’s goals is to help people
maintain their independence and live safely at home for as long as possible.”
Participants in the Meals-on-Wheels program in Forsyth
County, North Carolina, were recruited to take part in a five-month,
single-blind randomized trial.
Sixty-eight study participants received either a monthly
vitamin D supplement of 100,000 international units or placebo delivered with
their MOW meal. The study included the participants’ history of falls and their
fear of falling, blood tests at the beginning and at end of the trial to
measure 25-hydroxyvitamin D (biomarker for vitamin D in blood), and a monthly
diary recording falls during the trial period.
At the beginning of this pilot study, the research team
found that more than half of the participants had insufficient concentrations
of vitamin D in the blood (less than 20 ng/ml), while less than a quarter had
concentrations in the optimal range (30 ng/ml or more).
The study showed that the monthly vitamin D supplement
was effective in increasing the concentrations of vitamin D in the blood from
insufficient to sufficient levels in all but one of the 34 people who received
it, and to optimal levels in all but five people. In addition, people in the
vitamin D group reported approximately half the falls of those in the control
“Although these initial findings are encouraging, we need
to confirm the results in a larger trial,” Houston said.
The Wake Forest Baptist team currently is conducting a
clinical trial to try to determine how vitamin D affects risk factors for falls
such as balance and muscle strength and power.
Funding for the study was provided by the Wake Forest
Translational Science Institute and Center for Integrative Medicine and the Claude Pepper Older Americans Independence
Center of Wake Forest Baptist.
Co-authors are Janet Tooze, Ph.D., Jamehl Demons, M.D.,
Brooke Davis, M.S., Rachel Shertzer-Skinner, M.A., Stephen Kritchevsky, Ph.D.,
and Jeff Williamson, M.D., of Wake Forest Baptist; and Linda Kearsley, B.S.,
Senior Services Inc., Winston-Salem.