Short-term vitamin D + counseling may slash falls in malnourished seniors

Only 10% of the people receiving the vitamin supplements reported falling at least once during the three month period, compared with 23% in the control group, Dutch scientists report in the Journal of the American Geriatrics Society​​.

Falls among the elderly individuals occur frequently and lead to substantial morbidity and mortality, but although research has already shown use of vitamin D supplements to reduce the risk, not all trials confirm these benefits. There have also been questions raised over the doses necessary to produce an effect.

“This is one of the first studies showing these effects in such a short period and in a participant sample consisting of exclusively malnourished individuals,”​ wrote the authors, led by Floor Neelemaat from the VU University Medical Center in Amsterdam.

“It would be of interest to study the cost effectiveness of this intervention in the future.”​

Recommendations​

In 2009, a team of international scientists published findings​ from their meta-analysis that concluded that existing recommendations for vitamin D are inadequate to prevent falls amongst the elderly.

Doses of vitamin D between 700 and 1,000 International Units (IU) may reduce the risk of falling by about 20%, said the results of the meta-analysis published in theBritish Medical Journal(BMJ). However, doses less than 700 IU had no benefits.

The new study, however, indicates that doses of less than 600 IU of the sunshine vitamin may be sufficient to reduce falls if they are provided along with calcium, a protein-rich diet and counseling.

Assessing falls​

Neelemaat and her co-workers recruited 210 people with an average age of 74 and randomly assigned to a control group or the intervention group, which provided an energy- and protein-enriched diet, plus a chew supplement containing 400 IU vitamin D3 and 500 mg of calcium per day (Calci-Chew D3, Nycomed bv), and telephone counseling by a dietitian for 3 months.

Results showed that only 10% in the intervention group fell at least once during the three month period, compared with 23% in the control group.

In addition, 41 falls were reported in the control group, compared with only 16 in the intervention group.

“The results of the present study did not confirm an increase in falls because of decreased muscle mass and strength,” explained the researchers.​

“Measurements of muscle mass and strength were crude and probably not sensitive enough to pick up small changes. Nevertheless, function improved.​

“Results may be ascribed to changes in neuromuscular function rather than to changes in muscular strength.​

“A vitamin D supplementation study showed neuromuscular improvements after a short-term intervention (16 weeks), which confirms that neuromuscular improvements may take place over a short period of time.”​

Source: Journal of the American Geriatrics Society​​
Published online ahead of print, Early View, doi: 10.1111/j.1532-5415.2011.03888.x
“Short-Term Oral Nutritional Intervention with Protein and Vitamin D Decreases Falls in Malnourished Older Adults”​
Authors: F. Neelemaat, P. Lips, J.E. Bosmans, A. Thijs, J.C. Seidell, M.A.E. van Bokhorst-de van der Schueren