title: Nutritional status in relation to balance and falls in the elderly: a preliminary look at serum folate.
abstract: OBJECTIVE
  In elderly persons, fall-related injury is a serious public health problem. We investigated the impact of essential nutritional elements on falls in the elderly.
  
  
  METHODS
  Clinical function, balance, gait and disability tests and health and nutritional status assessments were performed. All subjects were interviewed regarding the occurrence of falls in the last year. Blood tests for serum vitamin D, folate and B(12) were conducted among a randomly selected subsample of 54 participants in the same month.
  
  
  RESULTS
  One hundred 65- to 91-year-old volunteers participated in the study, and 29 of them fell at least once during the past year. The depression score was higher (indicating more depressive symptoms) among fallers compared with non-fallers (4.0 +/- 3.2 vs. 2.5 +/- 2.3, respectively). The overall function score (indicating better function) was marginally higher in non-fallers. Subsequent comparisons between fallers and non-fallers were adjusted for overall function and depression scores. Serum folate was significantly lower in fallers (9.5 +/- 7.1 vs. 16.2 +/- 6.7 ng/ml, p = 0.02). Dietary intake was equal in both groups. Correlation analyses indicate a significant association between vitamin D and the functional measurements: timed get up and go (negative), Berg balance test, overall functional score, lower extremity score and limitation score (positive correlation coefficients). Serum folate was highly and negatively associated with the number of falls and with prescribed medications and was the only protective factor against falls in a multivariate analysis.
  
  
  CONCLUSIONS
  Vitamin D was related to most functional and balance measurements. Serum folate was protective against falls. For every 1 ng/ml increase in serum folate the occurrence of falls decreased by 19%.
authors.affiliation: S. Daniel Abraham International Center for Health and Nutrition and Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel. dshahar@bgu.ac.il
authors.forename: Danit
authors.initials: D
authors.lastname: Shahar
authors.forename: Meital
authors.initials: M
authors.lastname: Levi
authors.forename: Ilan
authors.initials: I
authors.lastname: Kurtz
authors.forename: Shraga
authors.initials: S
authors.lastname: Shany
authors.forename: Irene
authors.initials: I
authors.lastname: Zvili
authors.forename: Ezra
authors.initials: E
authors.lastname: Mualleme
authors.forename: Avner
authors.initials: A
authors.lastname: Shahar
authors.forename: Orly
authors.initials: O
authors.lastname: Sarid
authors.forename: Itzik
authors.initials: I
authors.lastname: Melzer
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000097:blood / Q000453:epidemiology; D005260:Female; D005492:Folic Acid / Q000097:blood*; D016330:Frail Elderly; D005684:Gait / Q000502:physiology; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D004856:Postural Balance / Q000502:physiology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D014807:Vitamin D / Q000097:blood*
chemical_list: D014807:Vitamin D; D005492:Folic Acid