Serum vitamin D and falls in older women in residential care in Australia.
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.
Flicker
Leon
L
Department of Medicine-Geriatric Medicine, University of Western Australia, Perth, Australia. leonflic@cyllene.uwa.edu.au
Mead
Kate
K
MacInnis
Robert J
RJ
Nowson
Caryl
C
Scherer
Sam
S
Stein
Mark S
MS
Thomasx
Jennifer
J
Hopper
John L
JL
Wark
John D
JD
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
D014807:Vitamin D