A new study is challenging widely made assertions that vitamin D supplements decrease falls risk, particularly in community-dwelling adults over 65. According to the latest analysis, "there is little justification for prescribing vitamin D supplements to prevent falls"—a conclusion in direct contrast to recommendations published as late as January of this year.
Results of the research, e-published on April 24 in the Lancet (abstract only available for free), were based on a sequential analysis of 20 randomized controlled trials that encompassed 29,535 subjects. The trials were designed to assess the impact of vitamin D supplements, both with and without calcium, on falls prevention. The authors of the Lancet article were unequivocal in their conclusion: there was no demonstration of reduced risk above 15%, regardless of whether the vitamin D regimen was accompanied by calcium. "Further clinical trials of the effect of vitamin D supplements on falls might be difficult to justify," the authors write.
The findings mirrored similar conclusions reached by the same researchers around vitamin D's effects on fracture, cardiovascular events, cancer, and mortality. In all cases, they write, "existing trials reliably show that vitamin D supplementation, with or without calcium, does not produce clinically relevant effects." The Lancet article adds falls risk reduction to that list.
The study runs counter to several guidelines, including a consensus opinion published in the Journal of the American Geriatrics Society earlier this year. That opinion echoed a 2012 recommendation from the US Preventive Services Task Force (USPSTF), which advocated for vitamin D supplementation as part of falls prevention in community-dwelling adults aged 65 years or older.
Authors of the Lancet study defended their use of a 15% risk reduction rate in the analysis by writing that "treatment effects [smaller than 15%] are unlikely to be attractive to patients because the absolute benefit is small and does not justify the effort of taking the treatment. Furthermore, the results did not change when a 10% risk reduction threshold was used."
APTA provides education on exercise prescriptions for balance improvement and falls prevention, and offers other resources for physical therapists, such as how to develop consumer events on balance, falls, and exercise, and information on evidence-based falls programs. Members can also access an APTA pocket guide on falls risk reduction (.pdf) as well as take part in an online community where members can share information about falls prevention.
Research-related stories featured in News Now are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.
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