Falls in the elderly: they can be prevented by combining vitamin D and moderate physical activity

Light exercise and supplementation with high doses of vitamin D reduce the risk of falls in frail elderly people, i.e., those with an unstable health status and suffering from multiple chronic diseases, by more than 70%. Combining physical activity with vitamin supplements is therefore a very simple strategy to improve quality of life and especially to reduce the likelihood of fractures and bruises in the geriatric age group.

The findings, published in the Journal of Gerontology, come from a study conducted by researchers at Osaka University (Japan) among elderly nursing home residents.

Falls of the elderly: a widespread phenomenon with many consequencesze

Falls among the elderly are a serious health problem, especially among those residing in nursing homes where the risk is two to three times higher than among others. Falls can cause bruising, head trauma, fractures, especially femoral, and sometimes even death. In addition, individuals who have experienced one often for fear of falling again restrict the range of activities in their daily lives, becoming less and less self-sufficient. 

Previous research has indicated that risk factors for falls include several conditions, including muscle weakness and problems related to walking. It would also appear that the risk of recurrent falls is associated with depression. Vitamin D supplementation has been found to be one of the most effective interventions to prevent falls among the frail elderly, that is, those with unstable health status and frequent disabilities and illnesses. 

A study showed that by increasing daily vitamin D consumption in elderly people living in assisted living facilities, the rate of falls was found to be decreased by 22%, and increased vitamin D levels in the blood were associated with significant reduction in the rate of death due to falls. In the over-60s, vitamin D deficiency is very common.

Elderly people often follow an improper diet, have lower bowel function and limited exposure to daylight; therefore, they often do not reach the recommended level (30 ng/mL) of 25-hydroxyvitamin D in the blood. This molecule is a precursor to the active form of vitamin D (1,25-dihydroxyvitamin D), and it is the molecule that is usually measured in the blood test. Vitamin D is critical for bone growth and health and serves primarily to regulate the levels of several minerals in the body, particularly calcium and phosphorus, through several mechanisms:

• The regulation of renal calcium reabsorption,
• intestinal absorption of phosphorus and calcium,
• The processes of bone mineralization.

High doses of vitamin D and physical activity reduce the risk of falls by 72.4 percent 

In light of the link between vitamin D levels and the risk of falls, Japanese researchers, led by Masakazu Imaoka, compared the frequency of falls among 91 elderly residents of a nursing home who had been on different treatments, randomly assigned to each. One group of study participants had adhered only to a personalized program of light physical activity, two days a week; the second group had been assigned supplementation with 900 IU (about 22 micrograms) of vitamin D daily, while another set of participants had followed both strategies. 

The control group had not undergone any treatment. The results of the statistical analysis revealed that falls had decreased by 52.5 percent among the elderly who had engaged in light physical activity, and by 42.5 percent in the group that had consumed the vitamin D supplements. Incredibly, patients who had followed both interventions had revealed a 72.4 percent reduction in falls, compared with controls. These data suggested that in nursing institutions, preventive strategies for falls among the frail elderly should include a regulated program of low-frequency exercise and dietary vitamin D supplements.

A simple strategy to improve quality of life

According to the researchers who conducted the study, the combination of supplementation with high doses of vitamin D and light exercise is the most effective intervention to reduce falls in the frail elderly. Limiting falls means prolonging life expectancy, improving life quality and reducing medical and nursing care costs.   

Source: Masakazu Imaoka, et al. "Low-frequency Exercise and Vitamin D Supplementation Reduce Falls Among Institutionalized Frail Elderly.", International Journal of Gerontology.