Is vitamin D intake, insufficiency or deficiency associated with falls in community -dwelling, rural, post-menopausal women?
The purpose of this experimental, prospective, longitudinal study was to investigate the association of vitamin D intake and nutritional status, as measured by the serum biomarker 25-hydroxyvitamin D [25(OH)D], with incident falls among rural mid-Western women, aged 55 years and older. Falls are a leading cause of unintentional injury in older adults. Nutritional status, especially nutritional deficiency, is often neglected as an integral factor in fall risk assessment or fall prevention. An ecological model of health determinants was used to explore the interface of biological, behavioral, and environmental factors---including nutritional deficiency---that contribute to incident falls.
Eleven hundred and eighty independently living, randomly selected women participated in the study for four years. They were each randomly assigned treatment with calcium 1500 mg/d and vitamin D 1000 IU/d, calcium 1500 mg/d and vitamin D placebo, or calcium placebo and vitamin D placebo. Data relating to incident falls were collected over four years of participation.
A chi-square test for independence, two-tailed t test, univariate and stepwise logistic regression, and Pearson correlations were used to analyze data. Results indicated that there were no significant reductions in the incidence of falls, or the number of women who reported a fall, with vitamin D supplementation. There was no evidence of the efficacy of vitamin D supplementation for fall prevention in the community-dwelling, older adult, female population in this study.
Risk factors significantly associated with women reporting a fall included: taking 4+ medications a day; having hypertension, cataracts, or pneumonia; and taking medications such as antihypertensives, antiarrhythmics, antidepressants, and diuretics. Risk factors significantly associated with incident falls included: age; taking 4+ medications a day; having hypertension, cataracts, pneumonia, dizziness, or depression; taking antihypertensive, antiarrhythmic, and diuretic medications.
Recommendations for future research include the conduct of prospective, longitudinal studies with falls as the primary outcome. Studies should target populations, including women and men of different races and ethnic backgrounds, assessed as having multiple fall risks, including vitamin D deficiency.
0453: Womens studies