Dataset Information

Effectiveness of Vitamin D Supplements in Reducing the Risk of Falls among Older Adults: A Meta-Analysis of Randomized Controlled Trials.

ABSTRACT:

Background

The role of vitamin D in reducing the risk of falls in older adults has not been clearly demonstrated. This study examined the effectiveness of vitamin D supplementation in reducing the risk of falls in older adults.

Methods

Four databases (Cochrane Library, Embase, PubMed, and CINAHL) were searched without language restrictions or time limitations. These articles were comprehensively screened using EndNote version 20.1 software. A manual search of the reference lists of the identified studies was also performed. The analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The pooled evidence was analyzed using RevMan software version 5.4.

Results

Seventeen studies met inclusion criteria among 550 potentially relevant studies. The pooled analysis of 38,598 older adults showed that vitamin D supplementation decreased the odds of having at least one fall by 1% (odds ratio [OR]=1.01; 95% confidence interval [CI], 0.92-1.11; p=0.86); however, the difference was not statistically significant. Of eight studies with 19,946 older adults, the pooled analysis showed a 12% (OR=1.12; 95% CI, 0.97-1.29; p=0.11) decrease in the odds of having at least one fracture among older adults; however, the difference was also not statistically significant. Pooled subgroup analysis showed that neither low (<2,000 IU/day) nor high (≥2,000 and <4,000 IU/day) doses of vitamin D supplementation had any significant effect on the incidence of falls and fractures.

Conclusion

Vitamin D supplementation had no beneficial effect in reducing fall and fracture incidence among older adults.

SUBMITTER: Octary T

PROVIDER: S-EPMC10556715 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Effectiveness of Vitamin D Supplements in Reducing the Risk of Falls among Older Adults: A Meta-Analysis of Randomized Controlled Trials.

Octary Tiara T Gautama Made Satya Nugraha MSN Duong Hai H

Annals of geriatric medicine and research 20230901 3

<h4>Background</h4>The role of vitamin D in reducing the risk of falls in older adults has not been clearly demonstrated. This study examined the effectiveness of vitamin D supplementation in reducing the risk of falls in older adults.<h4>Methods</h4>Four databases (Cochrane Library, Embase, PubMed, and CINAHL) were searched without language restrictions or time limitations. These articles were comprehensively screened using EndNote version 20.1 software. A manual search of the reference lists o ...[more]

PMID: 37654099

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Project description:BackgroundVitamin D supplementation may prevent falls in older persons, but evidence is inconsistent, possibly because of dosage differences.ObjectiveTo compare the effects of 4 doses of vitamin D3 supplements on falls.Design2-stage Bayesian, response-adaptive, randomized trial. (ClinicalTrials.gov: NCT02166333).Setting2 community-based research units.Participants688 participants, aged 70 years and older, with elevated fall risk and a serum 25-hydroxyvitamin D [25-(OH)D] level of 25 to 72.5 nmol/L.Intervention200 (control), 1000, 2000, or 4000 IU of vitamin D3 per day. During the dose-finding stage, participants were randomly assigned to 1 of the 4 vitamin D3 doses, and the best noncontrol dose for preventing falls was determined. After dose finding, participants previously assigned to receive noncontrol doses received the best dose, and new enrollees were randomly assigned to receive 200 IU/d or the best dose.MeasurementsTime to first fall or death over 2 years (primary outcome).ResultsDuring the dose-finding stage, the primary outcome rates were higher for the 2000- and 4000-IU/d doses than for the 1000-IU/d dose, which was selected as the best dose (posterior probability of being best, 0.90). In the confirmatory stage, event rates were not significantly different between participants with experience receiving the best dose (events and observation time limited to the period they were receiving 1000 IU/d; n = 308) and those randomly assigned to receive 200 IU/d (n = 339) (hazard ratio [HR], 0.94 [95% CI, 0.76 to 1.15]; P = 0.54). Analysis of falls with adverse outcomes suggested greater risk in the experience-with-best-dose group versus the 200-IU/d group (serious fall: HR, 1.87 [CI, 1.03 to 3.41]; fall with hospitalization: HR, 2.48 [CI, 1.13 to 5.46]).LimitationsThe control group received 200 IU of vitamin D3 per day, not a placebo. Dose finding ended before the prespecified thresholds for dose suspension and dose selection were reached.ConclusionIn older persons with elevated fall risk and low serum 25-(OH)D levels, vitamin D3 supplementation at doses of 1000 IU/d or higher did not prevent falls compared with 200 IU/d. Several analyses raised safety concerns about vitamin D3 doses of 1000 IU/d or higher.Primary funding sourceNational Institute on Aging.

Project description:BackgroundThe effect of vitamin D supplementation on postural muscles of the trunk is of particular interest because low 25-hydroxyvitamin D [25(OH) D] levels are associated with decreased postural balance and increased risk of falls. Understanding the role of vitamin D supplementation plays in trunk muscle function of older adults is necessary, as this is a potentially modifiable factor to improve postural muscle function and decrease the risk of falling of older adults. The objective of this randomized controlled trial was to evaluate the effect of 12 months of vitamin D supplementation compared with placebo, on morphology and function of the trunk muscles of adults aged 50 to 79 years with low serum 25(OH) D levels.MethodsThis was a secondary analysis of a randomized, placebo-controlled, and double-blind clinical trial conducted between June 2010 and December 2013 in Tasmania, Australia. The clinical trial was registered with the Australian New Zealand clinical trial registration agency, ClinicalTrials.gov identifier: NCT01176344; Australian New Zealand Clinical Trials Registry: ACTRN 12610000495022. Participants were aged 50-79 years with ongoing symptoms of knee osteoarthritis and with low serum [25(OH) D] (12.5 to 60 nmol/L, 5.2 to 24 ng/mL). Participants were randomly assigned to either monthly 50 000 IU oral vitamin D3 (n = 104) or an identical placebo (n = 113) for 24 months as per clinical trial protocol. The primary outcomes in this pre-specified secondary analysis were between-group differences in change in size of rectus abdominis, transversus abdominis, internal oblique, external oblique, and lumbar multifidus muscles and function (assessed by change in thickness on contraction) of these muscles (excepting rectus abdominis) from baseline to 12 months. Muscle size was assessed using ultrasound imaging.ResultsOf 217 participants (mean age 63 years, 48% women), 186 (85.7%) completed the study. There were no significant between-group differences in change in size or function of the abdominal or multifidus muscles after 12 months of vitamin D supplementation.ConclusionsA monthly dose of 50 000 IU of vitamin D3 alone for 12 months does not affect the size or ability to contract trunk muscles of independent community-dwelling older adults with symptomatic knee osteoarthritis and low serum 25(OH) D levels regardless of body mass index status or degree of vitamin D deficiency. An effect of vitamin D supplementation on other aspects of trunk muscle function such as strength, power, or physical function cannot be ruled out.

Project description:Nutrition plays an important role in maintaining the overall health of older people. Inadequate intake may lead to impaired body function, higher morbidity, and mortality. Oral nutritional supplements (ONS) showed positive effect on the nutritional status of the elderly; however, systematic evidence is currently lacking on the effect of ONS on the elderly with anorexia. The current systematic review and meta-analysis included randomized controlled trial (RCT) articles to investigate the effectiveness of ONS on the main aspects of anorexia of aging (AA). By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, researchers independently searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and other gray literature resources for publications that met the inclusion criteria by October 2020. The Cochrane Risk of Bias Tools were used for quality assessment. The inverse-variance method was used for the fixed model (FM) while the DerSimonian-Laird method was used for the random model (RM). Respective 95% confidence intervals (95% CIs), mean difference (MD) or standardized mean difference (SMD) was used for indices in terms of effect size (ES). 2497 records were found through the systematic search, while 17 RCTs (n = 1204) were included, with a mean age of 81.9 years (range: 74-87 years). Supplementation occurred in the morning, mid-day, and evening, while the times varied from one to three times a day. The results of meta-analysis showed that, generally, ONS had a positive effect on the overall appetite, MD = 0.18, 95% CI (0.03, 0.33), p = 0.02, and consumption, MD = 1.43, 95% CI (0.01, 2.86), p = 0.05; but not significant in terms of other aspects of appetite: hunger, p = 0.73; fullness, p = 0.60; desire to eat, p = 0.80; preoccupation, p = 0.15. Additionally, it showed an increase in the overall energy intake, SMD = 0.46, 95% CI (0.29, 0.63), p < 0.001, in protein intake, SMD = 0.59, 95% CI (0.16, 1.02), p = 0.007, and in fat intake, MD = 3.47, 95% CI (1.98, 4.97), p < 0.001, while no positive effect was found on carbohydrates intake, p = 0.06. Significance differences were also found in the body weight, SMD = 0.53, 95% CI (0.41, 0.65), p < 0.001, and body mass index (BMI), MD = 0.53, 95% CI (0.12, 0.95), p = 0.01. Moreover, subgroup analyses were conducted according to the nutrient density with no positive results showed except for the low-density ONS on overall energy intake. The results of the present study indicated that ONS had beneficial effects on overall appetite, energy intake, body weight and BMI.

Project description:BackgroundFalls are the leading cause of injuries among older adults, and trips and slips are major contributors to falls.ObjectiveThe authors sought to compare the effectiveness of adding a component of surface perturbation training to usual gait/balance training for reducing falls and fall-related injury in high-risk older adults referred to physical therapy.DesignThis was a multi-center, pragmatic, randomized, comparative effectiveness trial.SettingTreatment took place within 8 outpatient physical therapy clinics.PatientsThis study included 506 patients 65+ years of age at high fall risk referred for gait/balance training.InterventionThis trial evaluated surface perturbation treadmill training integrated into usual multimodal exercise-based balance training at the therapist's discretion versus usual multimodal exercise-based balance training alone.MeasurementsFalls and injurious falls were assessed with a prospective daily fall diary, which was reviewed via telephone interview every 3 months for 1 year.A total of 211/253 (83%) patients randomized to perturbation training and 210/253 (83%) randomized to usual treatment provided data at 3-month follow-up. At 3 months, the perturbation training group had a significantly reduced chance of fall-related injury (5.7% versus 13.3%; relative risk 0.43) but no significant reduction in the risk of any fall (28% versus 37%, relative risk 0.78) compared with usual treatment. Time to first injurious fall showed reduced hazard in the first 3 months but no significant reduction when viewed over the entire first year.LimitationsThe limitations of this trial included lack of blinding and variable application of interventions across patients based on pragmatic study design.ConclusionThe addition of some surface perturbation training to usual physical therapy significantly reduced injurious falls up to 3 months posttreatment. Further study is warranted to determine the optimal frequency, dose, progression, and duration of surface perturbation aimed at training postural responses for this population.

Project description:ObjectiveThe objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and age, baseline walking performance, exercise traits, technology used, and the risk of bias.MethodsA literature search was carried out in the databases MEDLINE, CINAHL, CENTRAL, EMBASE, WoS, PsycInfo, and PEDro up to January 10, 2020. Studies with a randomized controlled trial design, people ≥60 years of age without neurological disorders, comparison group with other exercise or no exercise, and walking-related outcomes were included. Cochrane RoB2, meta-analysis, meta-regression, and Grading of Recommendations, Assessment, Development and Evaluation were used to estimate quality, treatment effect, covariates' effect, and the certainty of evidence, respectively.ResultsIn the studies included (n = 66), the overall risk of bias was low (n = 2), unclear (n = 48), or high (n = 16). Compared with comparison groups, exergaming interventions were more effective for walking improvements (standardized mean difference = -0.21; 95% CI = -0.36 to -0.06; 3102 participants, 58 studies; moderate-quality evidence) and more or equally effective (standardized mean difference = -0.32; 95% CI = -0.64 to 0.00; 1028 participants, 13 studies; low-quality evidence) after nonexergaming follow-up. The strongest effect for covariates was observed with the type of comparison group, explaining 18.6% of the variance.ConclusionFor older adults without neurological disorders, exergame-based training improved walking, and improvements were maintained at follow-up. Greater benefits were observed when exergaming groups were compared with inactive comparison groups. To strengthen the evidence, further randomized controlled trials on the effectiveness of gamified exercise intervention are needed.ImpactExergaming has an effect equivalent to other types of exercising on improving walking in older adults. Physical therapists and other rehabilitation professionals may consider exergaming as a promising form of exercise in this age group.

Dataset Information

Effectiveness of Vitamin D Supplements in Reducing the Risk of Falls among Older Adults: A Meta-Analysis of Randomized Controlled Trials.

Background

Methods

Results

Conclusion

Publications

Effectiveness of Vitamin D Supplements in Reducing the Risk of Falls among Older Adults: A Meta-Analysis of Randomized Controlled Trials.

Similar Datasets

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