title: A 2-Year Follow-Up After a 2-Year RCT with Vitamin D and Exercise: Effects on Falls, Injurious Falls and Physical Functioning Among Older Women.
abstract: BACKGROUND
  Both exercise and vitamin D are recommended means to prevent falls among older adults, but their combined effects on fall-induced injuries are scarcely studied.
  
  
  METHODS
  A 2-year follow-up of a previous 2-year randomized controlled trial with vitamin D and exercise (Ex) of 409 older home-dwelling women using a factorial 2 × 2 design (D-Ex-, D+Ex-, D-Ex+, D+Ex+). Besides monthly fall diaries, femoral neck bone mineral density (fn-BMD), and physical functioning were assessed at 1 and 2 years after the intervention.
  
  
  RESULTS
  After the intervention, S-25OHD concentrations declined to baseline levels in both supplement groups. The groups did not differ for change in fn-BMD or physical functioning, except for leg extensor muscle strength, which remained about 10% greater in the exercise groups compared with the reference group (D-Ex-). There were no between-group differences in the rate of all falls, but medically attended injurious falls reduced in D+Ex- and D-Ex+ groups compared with D-Ex-. However, all former treatment groups had less medically attended injured fallers, HRs (95% CI) being 0.62 (0.39-1.00) for D+Ex-, 0.46 (0.28-0.76) for D-Ex+, and 0.55 (0.34-0.88) for D+Ex+, compared with D-Ex-.
  
  
  CONCLUSIONS
  Exercise-induced benefits in physical functioning partly remained 2 years after cessation of supervised training. Although there was no difference in the rate of all falls, former exercise groups continued to have lower rate of medically attended injured fallers compared with referents even 2 years after the intervention. Vitamin D without exercise was associated with less injurious falls with no difference in physical functioning.
authors.affiliation: The UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Kirsti
authors.initials: K
authors.lastname: Uusi-Rasi
authors.affiliation: The UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Radhika
authors.initials: R
authors.lastname: Patil
authors.affiliation: The UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Saija
authors.initials: S
authors.lastname: Karinkanta
authors.affiliation: The UKK Institute for Health Promotion Research, Tampere, Finland.|Department of Orthopaedics and Trauma Surgery, Tampere University Hospital, Tampere Medical School, University of Tampere, Tampere, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Kannus
authors.affiliation: The UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Tokola
authors.affiliation: Department of Food and Environmental Sciences, University of Helsinki,Helsinki, Finland.
authors.forename: Christel
authors.initials: C
authors.lastname: Lamberg-Allardt
authors.affiliation: The UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Sievänen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D004311:Double-Blind Method; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D014807:Vitamin D / Q000627:therapeutic use*; D014947:Wounds and Injuries / Q000517:prevention & control*
chemical_list: D014807:Vitamin D
keywords: Exercise; Injurious falls; Physical functioning; Vitamin D