Vitamin D and Exercise in Fall Prevention

 

A 2-year randomized, controlled trial with 2-year follow-up to investigate if exercise and vitamin D supplementation could improve the performance of the neuromuscular system (muscle strength and balance) among the elderly and reduce falls and fall-related injuries.

 

Background

Falls are the leading cause of unintentional injuries and fractures in older adults. Although less than one in ten falls results in a fracture, about 20 % of falls lead to injury needing medical attention. Therefore, falls prevention is widely considered the most essential element in injury and fracture prevention programs in elderly populations. While vitamin D supplementation and exercise are recommended for prevention of falls for older people, results regarding these two factors are contradictory.

Aim

In this 2-year double-blind placebo-controlled vitamin D and open exercise intervention trial with four arms we investigated the separate and combined effects of multimodal exercise training and vitamin D supplementation in reducing falls and injurious falls, and in improving bone density and physical functioning among 70–80-year old home-dwelling women at risk for falling. After the intervention there was a 2-year follow-up period.

Methods

409 participants were randomly assigned to one of four groups:

  1. vitamin D 800 IU/d and exercise (D+Ex+)
  2. placebo and exercise (D-Ex+)
  3. vitamin D 800 IU/d without exercise (D+Ex-)
  4. placebo without exercise (D-Ex-).

The exercisers participated in supervised training two times a week during the first year and once a week during the following year. In addition to the supervised training sessions, the participants did daily exercises at home.

Primary outcome was monthly reported falls. Injurious falls were reported as a secondary outcome. In addition, bone density, physical functioning (muscle strength, balance and mobility), and vitamin D metabolism were assessed.

The trial was done between April 2010 and March 2013. The 2-year follow-up ended on March 2015.

Results

The risk for injurious falls more than halved with strength and balance training in home-dwelling older women, while neither exercise nor vitamin D affected the rate of falls. Exercise improved physical functioning. Future research is needed to determine the role of vitamin D in enhancement of strength, balance and mobility.

 

Intl. registration

Clinical Trials NCT00986466

Contact

Kirsti Uusi-Rasi
Senior Researcher
kirsti.uusi-rasi(a)uta.fi

Publications

Uusi-Rasi K, Patil R, Karinkanta S, Kannus P, Tokola K, Lamberg-Allardt C, Sievänen H. A 2-year follow-up after a 2-year RCT with vitamin D and exercise: Effects on falls, injurious falls and physical functioning among older women. Journals of Gerontology. A. Medical Sciences 2017;72(9):1239-1245. doi.org/10.1093/gerona/glx044

Patil R, Karinkanta S, Tokola K, Kannus P, Sievänen H, Uusi-Rasi K. Effects of vitamin D and exercise on the wellbeing of older community-dwelling women: a randomized controlled trial. Gerontology 2016;62():401-408.

Uusi-Rasi K, Patil R, Karinkanta S, Tokola K, Kannus K, Lamberg-Allardt C, Sievänen H. Long-Term Effects of Vitamin D and Multimodal Exercise on Prevention of Injurious Falls in Older Women. A 2-year follow-up after intervention. J Bone Miner Res 31 (Suppl 1). Available at http://www.asbmr.org/Meetings/AnnualMeeting/AbstractDetail.aspx?aid=51d4e88b-f79d-47e2-a15b-134f0c57b52e. Accessed September 27, 2016.

Patil R, Kolu P, Raitanen J, Valvanne J, Kannus P, Karinkanta S, Sievänen H, Uusi-Rasi K: Cost-effectiveness of vitamin D supplementation and exercise in preventing injurious falls among older home-dwelling women: findings from an RCT. Osteoporos Int 2016; 27:193-201. Epub 2015 Jul 24. PMID: 26205890.

Uusi-Rasi K, Patil P, Karinkanta S, Kannus P, Tokola K, Lamberg-Allardt C, Sievänen H: Exercise and vitamin D in falls prevention among older women: A randomized controlled trial. JAMA Intern Med 2015; 175: 703-11. doi:10.1001/jamainternmed.2015.0225.

 

For all publications of this research, see the Finnish description. To find the list of publications "Julkaisuja", scroll the page down. To open the publication links, click "Lue lisaa" and "Lue julkaisu".

 

Updated April 2018

 
Last Modified: 24.04.2018

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