Citation

Aloia JF, Rubinova R, Fazzari M, Islam S, Mikhail M, Ragolia L. J. Am. Geriatr. Soc. 2019; 67(5): 1043-1049.

Affiliation

NYU Winthrop Hospital, Mineola, New York.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/jgs.15760

PMID

30698279

Abstract

BACKGROUND: Limited information is available on the influence of vitamin D on falls in older high-functioning black American women. Endocrine Society guidelines propose serum 25(OH)D levels over 30 ng/mL.

OBJECTIVE: To determine if maintenance of serum 25(OH)D above 30 ng/mL protects against falls.

DESIGN: The Physical Performance, Osteoporosis and Vitamin D in African American Women (PODA) trial had a prospective, randomized, placebo-controlled, double-dummy design with two arms: one with placebo and one with vitamin D₃ adjusted to maintain serum 25(OH)D above 30 ng/mL. The primary outcomes were the prevention of bone loss and the decline in physical performance. PATIENTS: The target population was healthy black women older than 60 years with serum 25(OH)D between 8 and 26 ng/mL. The trial was 3 years in duration with a falls questionnaire administered every 3 months. A total of 260 women entered the study, and 184 completed the 3 years. Mean age was 68.2 years. SETTING: Research center in an academic health center. MAIN OUTCOMES MEASURE: Prevention of falls. INTERVENTION: Participants were randomly assigned to placebo or active vitamin D. Vitamin D₃ dose was adjusted to maintain serum 25(OH)D above 30 ng/mL in the active group using a double-dummy design.

RESULTS: Baseline 25(OH)D was 22 ng/mL. Mean serum 25(OH)D reached 47 ng/mL in the active group compared with 21 ng/mL in the placebo group. There were 14.2% falls in the previous year recalled at baseline. During the study, 46% reported falling in the treatment group compared with 47% in the placebo group. There was no association of serum 25(OH)D or vitamin D dose with the risk of falling.

CONCLUSIONS: There is no benefit of maintaining serum 25(OH)D above 30 ng/mL compared with the Institute of Medicine recommendation (20 ng/mL) in preventing falls in healthy older black American women.

© 2019 The American Geriatrics Society.

Language: en

Keywords

falls; polypharmacy; race; vitamin D