Vitamin D for falls and fracture prevention

Studies have shown that vitamin D supplementation could be a cost effective way to help prevent falls and fractures in older adults.

When an older person falls, it can have devastating consequences. According to the WHO, the frequency of falls increases with age and frailty level. Older people who are living in nursing homes fall more often than those who live in the community. Approximately 30-50% of people living in long-term care institutions fall each year, and 40% of them experienced recurrent falls.1 Falls and fractures also have a huge human and socioeconomic cost. For example, Public Health England writes that falls are the most common cause of death from injury in the over 65s and cost the National Health Service over £2 billion a year and over 4 million bed days.2

Due the serious consequences of falls, researchers have studied various prevention strategies to help prevent falls in the elderly. One strategy, among many others, is vitamin D supplementation.

Why vitamin D is important

Vitamin D is essential for bone development and maintenance throughout life. As well as helping the body absorb calcium and acting to slow down bone mineral loss, vitamin D also affects muscle. Studies have shown that it can improve muscle strength and function, thereby reducing the risk of falls and fractures by about 20%. However, for various reasons, older people are highly susceptible to vitamin D deficiency – their skin is less efficient in producing vitamin D than in younger people, and many (especially those living in assisted care) are housebound or avoid going outdoors. Given the high rates of deficiency in the elderly and the evidence showing that vitamin D benefits musculoskeletal health and falls prevention, IOF recommends vitamin D supplementation at 800 to 1000 IU/day for falls and fracture prevention in adults aged 60 and older.3

A recent study published by the journal Pharmacokinetics determined that vitamin D supplementation along with an annual medication review are cost-effective interventions that reduce falls and provide health benefits in older adults living in assisted living facilities. Data of the effectiveness was derived from reviews of different trials. The interventions were defined as effective if they reduced the risk of injury after a fall or reduced the risk of falling. The researchers found that  vitamin D supplementation and annual medication reviews were more effective and less costly in comparison to no intervention and hip protectors.4

Falls occur as a result of a complex interaction of risk factors 

There is of course no quick fix to preventing falls in the elderly. Falls occur as a result of a complex interaction of risk factors which include various biological, behavioural, environmental and socioeconomic factors. Reducing environmental risks such as slippery floors, loose rugs, or poor lighting is naturally a basic first step. In reducing biological risk factors, it appears that vitamin D supplementation may be an effective low cost option within a multi-faceted falls prevention strategy for seniors living in assisted care facilities.

LYB logoThis article appeared in our bimonthly Love Your Bones newsletter sent to IOF members.

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