Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials
Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, Wong JB, Egli A, Kiel DP, Henschkowski J
BMJ (Clinical research ed.) · 760 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute on Aging
- Gobierno
- NIA NIH HHS
- Subvenciones
- National Institute on Aging (P01AG004390)
Según 2 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2009-10-01 · BMJ · vol. 339 · número oct01 1 · pág. b3692
- Citado
- 1,280 citas · más que el 100% de estudios similares · 12.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 50 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC
- Áreas de investigación
- Vitamin D Research Studies · Balance, Gait, and Falls Prevention · Bone health and osteoporosis research
- Palabras clave
- vitamin D supplementation, fall prevention, older adults, vitamin D3, vitamin D2, active vitamin D, 1α-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, calcium supplementation, fall risk, serum 25-hydroxyvitamin D, vitamin D dose, vitamin D deficiency, falls in older women
- MeSH
- humans, calcium, vitamin d, administration, oral, risk factors, accidental falls, dietary supplements, aged, aged, 80 and over, female, male, bone density conservation agents, randomized controlled trials as topic
10 autores
- Heike Annette Bischoff-Ferrari🇨🇭 · autor de correspondenciaUniversity of Zurich
- Bess Dawson‐Hughes🇺🇸Tufts University; Jean Mayer Human Nutrition Research Center on Aging
- Hannes B. Staehelin🇨🇭University Hospital of Basel
- Endel John Orav🇺🇸Harvard University
- Andreas Ernst Stuck🇨🇭University of Bern; University Hospital of Bern
- R. Theiler🇨🇭Triemli Hospital
- John B. Wong🇺🇸Tufts Medical Center
- Andreas Egli🇨🇭University of Zurich
- Douglas P. Kiel🇺🇸Harvard University
- Jana Henschkowski🇨🇭University of Bern; University of Zurich; University Hospital of Bern
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To test the efficacy of supplemental vitamin D and active forms of vitamin D with or without calcium in preventing falls among older individuals.
Data sources
We searched Medline, the Cochrane central register of controlled trials, BIOSIS, and Embase up to August 2008 for relevant articles. Further studies were identified by consulting clinical experts, bibliographies, and abstracts. We contacted authors for additional data when necessary. Review methods Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D(3) (cholecalciferol) or vitamin D(2) (ergocalciferol)) or an active form of vitamin D (1alpha-hydroxyvitamin D(3) (1alpha-hydroxycalciferol) or 1,25-dihydroxyvitamin D(3) (1,25-dihydroxycholecalciferol)) and with sufficiently specified fall assessment were considered for inclusion.
Results
Eight randomised controlled trials (n=2426) of supplemental vitamin D met our inclusion criteria. Heterogeneity among trials was observed for dose of vitamin D (700-1000 IU/day v 200-600 IU/day; P=0.02) and achieved 25-hydroxyvitamin D(3) concentration (25(OH)D concentration: or=60 nmol/l; P=0.005). High dose supplemental vitamin D reduced fall risk by 19% (pooled relative risk (RR) 0.81, 95% CI 0.71 to 0.92; n=1921 from seven trials), whereas achieved serum 25(OH)D concentrations of 60 nmol/l or more resulted in a 23% fall reduction (pooled RR 0.77, 95% CI 0.65 to 0.90). Falls were not notably reduced by low dose supplemental vitamin D (pooled RR 1.10, 95% CI 0.89 to 1.35; n=505 from two trials) or by achieved serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l (pooled RR 1.35, 95% CI 0.98 to 1.84). Two randomised controlled trials (n=624) of active forms of vitamin D met our inclusion criteria. Active forms of vitamin D reduced fall risk by 22% (pooled RR 0.78, 95% CI 0.64 to 0.94).
Conclusions
Supplemental vitamin D in a dose of 700-1000 IU a day reduced the risk of falling among older individuals by 19% and to a similar degree as active forms of vitamin D. Doses of supplemental vitamin D of less than 700 IU or serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l may not reduce the risk of falling among older individuals.
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