title: Falls relate to vitamin D and parathyroid hormone in an Australian nursing home and hostel.
abstract: OBJECTIVE
  To determine whether falling relates to serum levels of vitamin D and parathyroid hormone.
  
  
  METHODS
  A cross-sectional study with retrospective analysis.
  
  
  METHODS
  An aged-care institution in Melbourne Australia.
  
  
  METHODS
  Ambulant nursing home and hostel residents (n = 83).
  
  
  METHODS
  Frequency of falling, frequency of going outdoors, use of cane or walker, age, sex, weight, type of accommodation, and duration of residence. Serum concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and parathyroid hormone (PTH). Plasma concentrations of albumin, calcium, phosphate, and creatinine. Use of furosemide or non-benzodiazepine anticonvulsants.
  
  
  RESULTS
  Median age of residents was 84 years. The cohort was vitamin D deficient with a median (interquartile range) 25-hydroxyvitamin D level of 27 (18-37) nmol/L (one-third the reference range median), P < .001. The median (interquartile range) PTH of 5.2 (3.8-7.7) pmol/L exceeded the reference range median, P < .001. Residents who fell (n = 33) had lower serum 25-hydroxyvitamin D levels than other residents (medians 22 vs 29 nmol/L, P = .02) and higher serum PTH levels (medians 6.2 vs 4.8 pmol/L, P < .01). Sixty residents lived in the hostel (72%), and 41 (49%) walked without any walking aid. In a multiple logistic regression for falling, higher serum PTH remained independently associated with falling, with an odds ratio (95% confidence interval) for falling of 5.6 (1.7-18.5) per unit of the natural logarithm of serum PTH. Other terms in the regression were hostel accommodation, odds ratio .04 (.01-.25), and ability to walk without aids, odds ratio .07 (.01-.37).
  
  
  CONCLUSIONS
  In ambulant nursing home and hostel residents, residents who fall have lower serum 25-hydroxyvitamin D and higher serum parathyroid hormone levels than other residents. The association between falling and serum PTH persists after adjustment for other variables.
authors.affiliation: University of Melbourne, Department of Medicine, The Royal Melbourne Hospital, Australia.
authors.forename: M S
authors.initials: MS
authors.lastname: Stein
authors.forename: J D
authors.initials: JD
authors.lastname: Wark
authors.forename: S C
authors.initials: SC
authors.lastname: Scherer
authors.forename: S L
authors.initials: SL
authors.lastname: Walton
authors.forename: P
authors.initials: P
authors.lastname: Chick
authors.forename: M
authors.initials: M
authors.lastname: Di Carlantonio
authors.forename: J D
authors.initials: JD
authors.lastname: Zajac
authors.forename: L
authors.initials: L
authors.lastname: Flicker
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D001315:Australia / Q000453:epidemiology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D009735:Nursing Homes; D010281:Parathyroid Hormone / Q000097:blood*; D012112:Residential Facilities; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D