Vitamin D3 Supplementation No Benefit for Fall Prevention

TUESDAY, Dec. 8, 2020 -- Vitamin D₃ supplementation at doses of 1,000 IU/day or higher does not prevent falls among older persons with elevated fall risk, according to a study published online in the Dec. 1 issue of the Annals of Internal Medicine.

Lawrence J. Appel, M.D., M.P.H., from Johns Hopkins University in Baltimore, and colleagues compared the effect of four doses of vitamin D₃ supplements (200 [control]; 1,000; 2,000; or 4,000 IU/day) on falls among 688 participants, aged 70 years and older, with elevated fall risk and serum 25-hydroxyvitamin D level of 25 to 72.5 nmol/L. Participants were randomly assigned to one of the four doses in a dose-finding stage, and the best dose was determined for preventing falls. Participants were subsequently randomly assigned to receive either 200 IU/day or the best dose after dose finding.

The researchers found that the primary outcome rates were higher for the 2,000 and 4,000 IU/day doses than for the 1,000 IU/day dose, which was selected as the best dose. Event rates did not differ significantly between participants with experience receiving the best dose and those randomly assigned to receive 200 IU/day. In the experience-with-best-dose group versus the 200 IU/day group, analysis of falls with adverse outcomes suggested greater risk (serious fall: hazard ratio, 1.87; fall with hospitalization: hazard ratio, 2.48).

"This trial has implications for patients, clinicians, and policymakers," the authors write. "The study found no beneficial effect on fall prevention from supplemental vitamin D at doses of 1,000 IU/d or higher compared with 200 IU/d."

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Posted: December 2020