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Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials
British Medical Journal, 10/09/09

Bischoff–Ferrari HA et al. – Supplemental vitamin D in a dose of 700–1000 IU a day reduced the risk of falling among older individuals by 19% and to a similar degree as active forms of vitamin D. Doses of supplemental vitamin D of less than 700 IU or serum 25–hydroxyvitamin D concentrations of less than 60 nmol/l may not reduce the risk of falling among older individuals.

Methods

The authors searched Medline, the Cochrane central register of controlled trials, BIOSIS, and Embase up to August 2008 for relevant articles.
Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D3 (cholecalciferol) or vitamin D2 (ergocalciferol) or an active form of vitamin D or 1,25–dihydroxyvitamin D3 and with sufficiently specified fall assessment were considered for inclusion.

Results

Eight randomised controlled trials (n=2426) of supplemental vitamin D met the authors' inclusion criteria. Heterogeneity among trials was observed for dose of vitamin D (700–1000 IU/day v 200–600 IU/day; P=0.02) and achieved 25–hydroxyvitamin D3 concentration (25(OH)D concentration: <60 nmol/l v >= 60 nmol/l; P=0.005).
High dose supplemental vitamin D reduced fall risk by 19%, whereas achieved serum 25(OH)D concentrations of 60 nmol/l or more resulted in a 23% fall reduction.
Falls were not notably reduced by low dose supplemental vitamin D or by achieved serum 25–hydroxyvitamin D concentrations of less than 60 nmol/l.
Two randomised controlled trials (n=624) of active forms of vitamin D met the authors' inclusion criteria. Active forms of vitamin D reduced fall risk by 22%.

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