title: Serum vitamin D and falls in older women in residential care in Australia.
abstract: OBJECTIVE
  To determine the prevalence of vitamin D deficiency in older people in residential care and the influence that the level of vitamin D may have on their incidence of falls.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Residential care facilities for older people in several states of Australia.
  
  
  METHODS
  Six hundred sixty-seven women in low-level care and 952 women in high-level care, mean age 83.7 years.
  
  
  METHODS
  Serum 25-hydroxyvitamin D (25D) levels and recognized risk factors for falls including current medication use, a history of previous fractures, weight, tibial length (as a surrogate for height), cognitive function, walking ability, and frequency of going outdoors were determined. The women in low-level care and high-level care were followed for an average of 145 and 168 days, respectively. Falls were recorded prospectively in diaries completed monthly by residential care staff.
  
  
  RESULTS
  Vitamin D deficiency (defined as a serum 25D level below 25 nmol/L) was present in 144 (22%) women in low-level care and 428 (45%) in high-level care. After excluding 358 bed-bound residents and adjusting for weight, cognitive status, psychotropic drug use, previous Colles fracture, and the presence of wandering behavior, log serum 25D level remained independently associated with time to first fall. The adjusted hazards ratio was 0.74 (95% confidence interval=0.59-0.94; P=.01), implying a 20% reduction in the risk of falling with a doubling of the vitamin D level.
  
  
  CONCLUSIONS
  Vitamin D deficiency is common in residential care in Australia. A low level of serum vitamin D is an independent predictor of incident falls.
authors.affiliation: Department of Medicine-Geriatric Medicine, University of Western Australia, Perth, Australia. leonflic@cyllene.uwa.edu.au
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.forename: Kate
authors.initials: K
authors.lastname: Mead
authors.forename: Robert J
authors.initials: RJ
authors.lastname: MacInnis
authors.forename: Caryl
authors.initials: C
authors.lastname: Nowson
authors.forename: Sam
authors.initials: S
authors.lastname: Scherer
authors.forename: Mark S
authors.initials: MS
authors.lastname: Stein
authors.forename: Jennifer
authors.initials: J
authors.lastname: Thomasx
authors.forename: John L
authors.initials: JL
authors.lastname: Hopper
authors.forename: John D
authors.initials: JD
authors.lastname: Wark
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015999:Multivariate Analysis; D011446:Prospective Studies; D012112:Residential Facilities; D016019:Survival Analysis; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology
chemical_list: D014807:Vitamin D