There has been an explosion of research regarding vitamin D – more than 2,000 studies in the past seven years.1 Much of that has revolved around whether vitamin D supplements can prevent fractures and accidental falls. This is an important topic. Every 20 minutes, an older American dies from a fall.2 Home health agencies stand out as a very important option for fall prevention rehab. Vitamin D supplementation is growing in popularity with home health agencies due to recommendations from the Centers for Disease Control, US Preventive Services Task Force, and other authorities.3
Controversy Regarding Vitamin D Supplementation
However, there is some controversy. Some experts have asserted that vitamin D supplementation only prevents falls and fractures in specific target groups, not the population as a whole. They question whether untargeted recommendations are a good idea given the possibility of adverse cardiovascular effects.4
A Summary of the Recent Research on Vitamin D Supplementation and Fall Injuries
To help put the whole issue in perspective, Professor Marlene Chakhtoura and colleagues, writing for the World Health Organization Collaboration Center for Metabolic Bone Disorders, performed a systematic review of recent studies. The journal Bone published their study earlier this year.1 They reviewed the results of 13 meta-analyses published since 2012. These meta-analyses each took several randomized controlled trials and combined the results to achieve higher-powered conclusions. Chakhtoura’s systematic review proved no easy task. The existing research is highly variable in terms of subjects, dosages, definitions, and follow-up periods. Some studies found that vitamin D supplementation produced worthwhile effects on fall risk, while others did not.
Nevertheless, Chakhtoura et al. were able to reach some interesting conclusions. One, supplementation of vitamin D with calcium significantly reduces fracture rates. The effect on fall rates is less clear. Researchers conclude that supplementation with vitamin D3 in combination with calcium is prudent. The most significant effect will be seen among people age 70 plus and who are already at a high risk for accidental falls. Daily supplementation at doses ranging between 800 and 1,000 IU seems more effective than intermittent dosing. On the other hand, they do not recommend widespread blood testing to see who is vitamin D deficient. The research team suggests blood testing should be reserved for people at a high risk of fall injuries, such as seniors with a history of accidental falls.
Can vitamin D supplementation prevent fall injuries? Different scientists have used different methods and reached conclusions that seem at odds with each other. However, professor Marlene Chakhtoura’s research team concludes that the preponderance of recent scientific trials shows there is a positive effect, especially when it comes to preventing fractures among high-risk individuals. This may not be the final word. The authors of the recent review note that there is much we do not fully understand about how vitamin D works in the body.
- Chakhtoura M, Chamoun N, Rahme M, Fuleihan GE. Impact of vitamin D supplementation on falls and fractures—A critical appraisal of the quality of the evidence and an overview of the available guidelines. Bone. 2020 Feb 1;131:115112.
- Bergen G, Stevens MR, Burns ER. Falls and Fall Injuries Among Adults Aged ≥65. MMWR Morb Mortal Wkly Rep. 2016; 65: 993–998.
- Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL. Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018 Apr 24;319(16):1705-16.
- Lewis JR, Sim M, Daly RM. The vitamin D and calcium controversy: an update. Current Opinion in Rheumatology. 2019 Mar 1;31(2):91-7.