Higher doses of vitamin D heighten risk of falls in older people

2016 ◽  
Author(s):  
Terry J Aspray ◽  
Roger M Francis ◽  
Elaine McColl ◽  
Thomas Chadwick ◽  
Elaine Stamp ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2335
Author(s):  
Fuyuko Takahashi ◽  
Yoshitaka Hashimoto ◽  
Ayumi Kaji ◽  
Ryosuke Sakai ◽  
Yuka Kawate ◽  
...  

The aim of this prospective cohort study was to examine the relationships between the intakes of various vitamins and the loss of muscle mass in older people with type 2 diabetes (T2DM). The change in skeletal muscle mass index (SMI, kg/m2) (kg/m2/year) was defined as follows: (SMI at baseline (kg/m2) − SMI at follow-up (kg/m2))/follow-up period (year). The rate of SMI reduction (%) was calculated as follows (the change in SMI (kg/m2/year)/SMI at baseline (kg/m2)) × 100. The rate of SMI reduction ≥ 1.2% was considered as the loss of muscle mass. Among 197 people with T2DM, 47.2% of them experienced the loss of muscle mass at the 13.7 ± 5.2 month follow-up. Vitamin B1 (0.8 ± 0.3 vs. 0.8 ± 0.3 mg/day, p = 0.031), vitamin B12 (11.2 ± 8.3 vs. 13.4 ± 7.5 μg/day, p = 0.049), and vitamin D (16.5 ± 12.2 vs. 21.6 ± 13.0 μg/day, p = 0.004) intakes in people with the loss of muscle mass were significantly lower than those without. Vitamin D intake was related to the loss of muscle mass after adjusting for sex, age, exercise, alcohol, smoking, body mass index, SMI, glucagon-like peptide-1 agonist, sodium glucose cotransporter-2 inhibitor, insulin, HbA1c, creatinine, energy intake, and protein intake (adjusted odds ratio 0.93, 95% confidence interval: 0.88–0.97, p = 0.003). This study showed that vitamin D intake was related to the loss of muscle mass in older people with T2DM. Vitamin B12 intake tended to be related to the loss of muscle mass, although vitamin A, vitamin B2, vitamin B6, vitamin C, and vitamin E intake were not related.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 758-759
Author(s):  
Jennifer Schrack ◽  
Lawrence Appel ◽  
Lewis Lipsitz

Abstract Each year, 2.8 million older adults are treated for falls, with over 800,000 hospitalized. Evidence suggests vitamin D supplementation might reduce the risk of falls, potentially through improvements in skeletal muscle function; however, results are inconsistent. In 2013 the NIA issued a request for applications to assess the efficacy and dose-response of vitamin D supplementation for fall prevention across a range of doses and serum 25(OH)D concentrations, resulting in the funding of STURDY (Study To Understand Fall Reduction and Vitamin D in You). STURDY was a seamless dose-finding and confirmatory, double-masked, response adaptive Bayesian randomized trial designed to find the best dose of vitamin D supplementation for fall prevention. Participants (n=688, ≥70 years with serum 25(OH)D of 10-29 ng/mL) were randomized to 200 (control), 1000 , 2000, or 4000 IU/day of vitamin D3.The first participant was randomized on 10/30/2015 and data collection ended on 5/31/2019. The primary outcome was time to first fall or death, and the secondary outcome was gait speed. Dr. Appel will present the main findings of the effect of vitamin D supplementation on time to first fall. Dr. Wanigatunga will present a more detailed analysis of the effect of vitamin D supplementation on fall characteristics, including indoor vs. outdoor falls, consequential falls, and repeat fall risk. Dr. Guralnik will present the effect of vitamin D supplementation on physical functioning, including gait speed, SPPB, 6-minute walk, and TUG performance. Dr. Schrack will present the effect of vitamin D supplementation on objectively measured physical activity.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 759-759
Author(s):  
Lawrence Appel ◽  
Jennifer Schrack ◽  
Erin Michos ◽  
Christine Mitchell ◽  
Stephen Juraschek ◽  
...  

Abstract STURDY was a Bayesian, response-adaptive trial with dose-finding and confirmatory stages. Participants (n=688; ≥70years with serum 25(OH)D of 10-29ng/mL) were randomized to 200 (control), 1000, 2000, or 4000 IU/day of vitamin D3. The primary outcome was time to first fall or death over 2 years. During dose-finding, the best non-control dose was determined to be 1000IU/day based on higher primary outcome event rates in the 2000 and 4000IU/day doses than the 1000IU/day dose (posterior probability of being best dose=0.90; hazard ratios[HR] were 1.86 [95%CI: 1.16-2.97] and 1.68 [95%CI: 1.05-2.69], respectively). Participants were then switched from other non-control doses to 1000IU/day, and event rates did not differ between the pooled higher doses and control groups (HR=1.02, P=0.84). There was no heterogeneity by baseline 25(OHD). In conclusion, high-dose vitamin D supplementation ≥1000IU/day did not prevent falls. Whether vitamin D doses >2000IU/day increase the risk of falls is uncertain.


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
K Ibrahim ◽  
M A Mullee ◽  
G Lily Yao ◽  
S Zhu ◽  
M Baxter ◽  
...  

Abstract Introduction Osteoporosis and sarcopenia often co-exist (osteo-sarcopenia) and both are associated with increased risk of falls and fractures. Early identification and treatment of sarcopenia among older people with fragility arm fractures could prevent further fractures. This study evaluated the feasibility of assessing sarcopenia in a fracture clinic. Methods People aged 65+ years with arm fracture attending fracture clinics in one acute trust were recruited. Sarcopenia was assessed using gait speed, grip strength with unfractured arm (hand dynamometer using appropriate cut off adjusted for age and gender), skeletal muscle mass index SMI (Bioimpedance BIA), SARC-F questionnaire, the European Working Group on Sarcopenia in Older People (EWGSOP) I and II criteria. The sensitivity and specificity of each measure was calculated against the EWGSOP II criteria as the standard reference. Results 100 patients (Mean age 75 years±7.2; 80 female) were recruited. Sarcopenia was identified among 4% (EWGSOP I), 5% (SMI), 13% (EWGSOP II), 16% (gait speed test), 18% (SARC-F) and 39% (grip strength) and was more prevalent among men. SARC-F had the best sensitivity and specificity (100% and 96% respectively) when compared to the EWGSOP II criteria. Sensitivity and specificity for the remaining measures were respectively (100%, 71%) for grip strength, (75%, 94%) for gait speed, (25%, 97%) with SMI and (25%, 99%) for EWGSOP I. Time needed to complete the assessments was 1–2 minutes for gait speed, grip strength and SARC-F; five minutes for BIA test, and nine minutes when EWGSOP I and II criteria were applied. Data were complete for grip strength and SARC-F. Missing data was reported among 2% for gait speed, 8% for BIA test, 8% for EWGSOP II and 10% for EWGSOP I. Conclusion It was feasible to assess sarcopenia in fracture clinics and SARC-F was a quick, simple and sensitive tool suitable for routine use.


2005 ◽  
Vol 34 (5) ◽  
pp. 425-426 ◽  
Author(s):  
Frazer Anderson
Keyword(s):  

2017 ◽  
Vol 73 (9) ◽  
pp. 1205-1211 ◽  
Author(s):  
Shiho Takada ◽  
Yosuke Yamamoto ◽  
Sayaka Shimizu ◽  
Miho Kimachi ◽  
Tatsuyoshi Ikenoue ◽  
...  

2021 ◽  
Vol 4 (2) ◽  
pp. 81-88
Author(s):  
Gamze Dilek ◽  
Yalkin Calik ◽  
Kagan Ozkuk
Keyword(s):  

2021 ◽  
Vol 11 (1) ◽  
pp. 114-123
Author(s):  
Zakia Azkia ◽  
Rahmi Setiyani ◽  
Lita Heni Kusumawardani

Background: Falls are a significant health problem and the most common cause of injuries in older people. Different types of exercise have been recommended to prevent falls, including balance exercise and range of motion. However, there is a lack of evidence to compare the effect of the two exercises.Purpose: This study aimed to compare the effect of Balance Strategy Exercise (BSE) and Lower Limb-Range of Motion (ROM) exercise on reducing the risk of falls among older people living in long-term care facilities. Methods: This was a quasi-experimental study using a pre-post design without a control group. A total of 30 older adults from two nursing homes who met the inclusion and exclusion criteria participated in the study. A cluster randomization technique was used to assign the older people into either BSE or Lower-Limb ROM groups evenly. Treatment was given for 30 minutes per session, three sessions per week for three weeks. The risk of falls was measured using the Timed Up and Go (TUG) test. The paired t-test, Wilcoxon and Mann-Whitney U-test were used to analyze the data. Results: Results showed significant differences in the TUG scores before and after the intervention within both the BSE (p=0.001) and the Lower Limb-ROM group (p=0.001). However, the Lower Limb-ROM group demonstrated a significantly higher reduction in TUG score than the BSE group after the intervention (p=0.008).Conclusion: Lower Limb-ROM exercise is better to reduce the risk of falls among older people living in institutional care than BSE. This exercise can be applied as part of a fall prevention program in nursing homes.


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