title: Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial.
abstract: OBJECTIVE
  To determine whether vitamin D supplementation can reduce the incidence of falls and fractures in older people in residential care who are not classically vitamin D deficient.
  
  
  METHODS
  Randomized, placebo-controlled double-blind, trial of 2 years' duration.
  
  
  METHODS
  Multicenter study in 60 hostels (assisted living facilities) and 89 nursing homes across Australia.
  
  
  METHODS
  Six hundred twenty-five residents (mean age 83.4) with serum 25-hydroxyvitamin D levels between 25 and 90 nmol/L.
  
  
  METHODS
  Vitamin D supplementation (ergocalciferol, initially 10,000 IU given once weekly and then 1,000 IU daily) or placebo for 2 years. All subjects received 600 mg of elemental calcium daily as calcium carbonate.
  
  
  METHODS
  Falls and fractures recorded prospectively in study diaries by care staff.
  
  
  RESULTS
  The vitamin D and placebo groups had similar baseline characteristics. In intention-to-treat analysis, the incident rate ratio for falling was 0.73 (95% confidence interval (CI)=0.57-0.95). The odds ratio for ever falling was 0.82 (95% CI=0.59-1.12) and for ever fracturing was 0.69 (95% CI=0.40-1.18). An a priori subgroup analysis of subjects who took at least half the prescribed capsules (n=540), demonstrated an incident rate ratio for falls of 0.63 (95% CI=0.48-0.82), an odds ratio (OR) for ever falling of 0.70 (95% CI=0.50-0.99), and an OR for ever fracturing of 0.68 (95% CI=0.38-1.22).
  
  
  CONCLUSIONS
  Older people in residential care can reduce their incidence of falls if they take a vitamin D supplement for 2 years even if they are not initially classically vitamin D deficient.
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. leonflic@cyllene.uwa.edu.au
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.forename: Robert J
authors.initials: RJ
authors.lastname: MacInnis
authors.forename: Mark S
authors.initials: MS
authors.lastname: Stein
authors.forename: Sam C
authors.initials: SC
authors.lastname: Scherer
authors.forename: Kate E
authors.initials: KE
authors.lastname: Mead
authors.forename: Caryl A
authors.initials: CA
authors.lastname: Nowson
authors.forename: Jenny
authors.initials: J
authors.lastname: Thomas
authors.forename: Chris
authors.initials: C
authors.lastname: Lowndes
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 / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D002119:Calcium Carbonate / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004872:Ergocalciferols / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000517:prevention & control; D016330:Frail Elderly; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D016017:Odds Ratio; D010349:Patient Compliance; D011446:Prospective Studies; D012112:Residential Facilities; D014739:Victoria
chemical_list: D004872:Ergocalciferols; D002119:Calcium Carbonate