Vitamin D and Exercise in Fall Prevention

A randomized, controlled trial 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

Both aging and a sedentary lifestyle are risk factors for poor health and they are linked to reduced balance thus increasing the risk of falling. Many older people who have not fallen are afraid of falling, which can then lead to the reduction of physical activity and therefore to an increased risk of falling.

Studies indicate that both exercise and vitamin D can prevent falls and fall-related injuries in the elderly. Just the reduction of the fear of falling may improve a person's quality of life. However, the evidence is ambiguous.

Exercise and vitamin D or their joint effect has never been studied in a clinical intervention setting. So far there is also no consensus as to what the exercise program and vitamin D intake should be in order to reduce falls. These factors are also not sufficiently taken into consideration by health care personnel or as part of services for senior citizens.

Aims

The aim was to investigate if exercise and vitamin D supplementation can help improve mobility, functional ability and bone health and thus prevent falls and fall-related injuries among women who live independently and are between the ages 70 and 79. The primary endpoints were the number of falls and injuries caused by falling, including fractures. In addition, the aim was to measure the changes in the performance and functioning of the neuromuscular system (balance, muscle strength) as well as the changes in bone mass and strength.

The aim was also to investigate if the fear of falling reduces and if the quality of life improves. The changes in the risk factors for cardiovascular diseases were also measured.

In addition to the Academy of Finland, the study was funded by the Ministry of Education and Culture and the Pirkanmaa Hospital District.

Methods

In this randomized controlled two-year trial, 400 women between the ages of 70 and 79 who live independently were put into four groups:

  1. exercise + vitamin D (20 μg/day)
  2. exercise + placebo
  3. no exercise + vitamin D (20 μg/day)
  4. no exercise + placebo.

 The exercise+ placebo group members 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.

At the beginning of the study and as part of the follow-ups, the participants were examined in terms of their general health and lifestyle. In addition, their fear of falling and quality of life was assessed and their bone density, functional ability and vitamin D metabolism was measured. In order to register the falls and fall-related injuries, all participants kept a diary of their falls which was handed in monthly to the UKK Institute.

The recruitment of participants and the initial assessments began in the autumn of 2009 and the actual training began in February or March 2010. The two-year intervention began in two parts in 2010 and 2011 with 200 new participants starting both years. The final assessments were conducted during 2012 and 2013.

Utilization

The study will provide information on how to maintain and improve the physical functioning of elderly people, prevent falls and fall-related injuries and reduce their fear of falling and improve their quality of life at the same time.

Schedule

2010—

Intl. registration

Clinical Trials NCT00986466

 

Contact

Kirsti Uusi-Rasi, Senior Researher

kirsti.uusi-rasi(at)uta.fi

Publications

For publications (international and Finnish) of this research see the Finnish description.
To find the list of publications (Julkaisuja), scroll the page down.

 
Last Modified: 27.11.2014

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