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Vitamin D supplements may reduce falls in older homebound adults
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A vitamin D intervention delivered through a Meals-on-Wheels program improved vitamin D concentrations in older adults who were homebound, while also reducing their rate of falls, according to research in Journal of the American Geriatrics Society.
In a single-blind, randomized trial, researchers found that delivery of a monthly vitamin D supplement to Meals-on-Wheels clients was a feasible option, with more than 90% of participants reporting receiving their doses.
“Falls in homebound older people often lead to disability and placement in a nursing home,” Denise Houston, PhD, RD, associate professor of gerontology and geriatric medicine at Wake Forest Baptist Medical Center, said in a press release. “One of our aging center’s goals is to help people maintain their independence and live safely at home for as long as possible.”
Houston and colleagues analyzed data from 68 adults aged 65 to 102 years (mean age, 78 years; 72% women; 75% black) who were homebound and receiving services from the Meals-on-Wheels food delivery program. More than half of participants reported having fallen in the past year and feeling afraid of falling. Meals-on-Wheels clients were randomly assigned 100,000 IU of monthly vitamin D (n = 38) or 400 IU monthly of vitamin E as a placebo (n = 30) for 5 months, depending on the delivery routes of drivers. The intervention took place between December 2010 and August 2011.
Researchers measured serum 25-hydroxyvitamin D at baseline and 5 months after randomization. Participants used monthly calendars to record each day whether they had fallen. Researchers used negative binomial generalized estimating equation models to estimate the rate of falls. The study coordinator contacted participants on the day supplements were delivered to confirm they had taken the supplements and were completing their fall calendars.
Researchers found that 57% of participants had a 25-(OH)D concentration of less than 20 ng/mL at baseline. Following 5 months of vitamin D intervention, only one participant in the vitamin D arm still had 25-(OH)D concentrations less than 20 ng/mL; compared with 18 participants in the placebo arm (P < .001).
The rate of falls between groups was not significantly different in unadjusted analyses, but after adjustment for sex, race, season of the year, baseline vitamin D status and history of falls, participants in the vitamin D arm had a lower rate of falling than those in the placebo arm (RR = 0.42; 95% CI, 0.21–0.87).
“Randomization to vitamin D supplementation resulted in a rate of falls in the intervention group that was approximately half that of the control group over the 5-month period,” the researchers wrote.
The researchers noted that the delivery of vitamin D supplements to homebound adults may help them remain independent for longer by reducing falls and their consequences. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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