Vitamin D Treatment for the Prevention of Falls in Older Adults: Systematic Review and Meta-Analysis

OBJECTIVES: To systematically review and quantitatively synthesize the effect of vitamin D therapy on fall prevention in older adults. DESIGN: Systematic review and meta‐analysis. SETTING: MEDLINE, CINAHL, Web of Science, EMBASE, Cochrane Library, LILACS, bibliographies of selected articles, and pre...

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Vydáno v:	Journal of the American Geriatrics Society (JAGS) Ročník 58; číslo 7; s. 1299 - 1310
Hlavní autoři:	Kalyani, Rita Rastogi, Stein, Brady, Valiyil, Ritu, Manno, Rebecca, Maynard, Janet W., Crews, Deidra C.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Malden, USA Blackwell Publishing Inc 01.07.2010 Wiley-Blackwell Wiley Subscription Services, Inc
Témata:	Accidental Falls - prevention & control Adults Aged Aged, 80 and over Analysis Bibliographic literature Bibliographies Biological and medical sciences Calcium Clinical trials Confidence intervals Criteria Data quality Dietary Supplements elderly Evaluation Falls Female Fractures General aspects Heterogeneity Humans Libraries Male Medical research Medical sciences Medical treatment Meta-analysis Miscellaneous Number needed to treat Older people Prevention Prevention and actions Preventive medicine Public health. Hygiene Public health. Hygiene-occupational medicine Quality assessment randomized controlled trials Risk Risk factors Systematic review Therapy Vitamin D Vitamin D - therapeutic use Vitamins Vitamins - therapeutic use Human Statistical analysis Evidence-based practice Controlled therapeutic trial Systematic review Review randomized controlled trials Evidence-based medicine Metaanalysis Prevention Gerontology Randomization Treatment falls Vitamin D Clinical trial Fall Elderly Bibliographic review Public health Geriatrics
ISSN:	0002-8614, 1532-5415, 1532-5415
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Shrnutí:	OBJECTIVES: To systematically review and quantitatively synthesize the effect of vitamin D therapy on fall prevention in older adults. DESIGN: Systematic review and meta‐analysis. SETTING: MEDLINE, CINAHL, Web of Science, EMBASE, Cochrane Library, LILACS, bibliographies of selected articles, and previous systematic reviews through February 2009 were searched for eligible studies. PARTICIPANTS: Older adults (aged ≥60) who participated in randomized controlled trials that both investigated the effectiveness of vitamin D therapy in the prevention of falls and used an explicit fall definition. MEASUREMENTS: Two authors independently extracted data, including study characteristics, quality assessment, and outcomes. The I2 statistic was used to assess heterogeneity in a random‐effects model. RESULTS: Of 1,679 potentially relevant articles, 10 met inclusion criteria. In pooled analysis, vitamin D therapy (200–1,000 IU) resulted in 14% (relative risk (RR)=0.86, 95% confidence interval (CI)=0.79–0.93; I2=7%) fewer falls than calcium or placebo (number needed to treat =15). The following subgroups had significantly fewer falls: community‐dwelling (aged <80), adjunctive calcium supplementation, no history of fractures or falls, duration longer than 6 months, cholecalciferol, and dose of 800 IU or greater. Meta‐regression demonstrated no linear association between vitamin D dose or duration and treatment effect. Post hoc analysis including seven additional studies (17 total) without explicit fall definitions yielded smaller benefit (RR=0.92, 95% CI=0.87–0.98) and more heterogeneity (I2=36%) but found significant intergroup differences favoring adjunctive calcium over none (P=.001). CONCLUSION: Vitamin D treatment effectively reduces the risk of falls in older adults. Future studies should investigate whether particular populations or treatment regimens may have greater benefit.
Bibliografie:	istex:F7D1E5186277090D36D666256C50194130BF0A57 ark:/67375/WNG-NVC1FMQ2-6 ArticleID:JGS2949 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-2 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 ObjectType-Review-3 ObjectType-Undefined-4 Author contributions: All authors: study design and concept, acquisition of data, interpretation of data. Brady Stein: analysis. Rita Kalyani: analysis and preparation of manuscript.
ISSN:	0002-8614 1532-5415 1532-5415
DOI:	10.1111/j.1532-5415.2010.02949.x