Does vitamin D stop inpatients falling? A randomised controlled trial.
BACKGROUND
Vitamin D deficiency is common in older people and may increase risk of falls and fracture. Hospital inpatients are at particular risk of falling. Previous studies suggest that vitamin D improves neuromuscular function and reduces falls.


OBJECTIVE
To determine whether routine supplementation with vitamin D plus calcium reduces numbers of fallers and falls in a cohort of hospital admissions while they are inpatients.


METHODS
Randomised, double-blind, controlled study.


METHODS
two hundred and five acute admissions >65 years to a geriatric medical unit.


METHODS
Patients were randomised to intervention of daily vitamin D 800 iu plus calcium 1,200 mg or control group of daily calcium 1,200 mg, until discharge or death.


RESULTS
Baseline characteristics were similar in both groups with a median age 84 years and a median length of stay = 30 days (IQR 14.75-71.00). In a pre-selected sub-group (54/205 participants), median admission vitamin D level = 22.00 nmol/l (IQR 15.00-30.50). This did not significantly increase in the treatment versus control group. Median study drug adherence = 88%, with no significant difference between study groups (Mann-Whitney: P = 0.711). Although there were fewer fallers in the vitamin D cohort, this did not reach statistical significance (vitamin D: calcium = 36:45 fallers; RR 0.82 (CI 0.59-1.16). Neither the mean number of falls (vitamin D: calcium = 1.040:1.155; Mann-Whitney P = 0.435) or time to first fall (Log-rank test P = 0.377) differed between groups.


CONCLUSIONS
In a population of geriatric hospital inpatients, vitamin D did not reduce the number of fallers. Routine supplementation cannot be recommended to reduce falls in this group.
Department of Medicine for the Elderly, Mansionhouse Unit, Victoria Infirmary, 21 Mansionhouse Road, Glasgow, G41 3DX, UK. Liz.Burleigh@sgh.scot.nhs.uk
Elizabeth
E
Burleigh
John
J
McColl
Jan
J
Potter
D000058:Accidental Falls / Q000517:prevention & control*; D002118:Calcium / Q000008:administration & dosage; D015331:Cohort Studies; D004311:Double-Blind Method; D006801:Humans; D007297:Inpatients; D010349:Patient Compliance; D011446:Prospective Studies; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000503:physiopathology
D014807:Vitamin D; D002118:Calcium