Vitamin D and falls prevention for senior patients; dosage, calcium

Vitamin D and falls prevention research has shown that senior patients with lower vitamin D levels have poorer functional mobility and cognitive function

Vitamin D is known for providing certain health benefits, including promoting calcium absorption (which supports bone health and proper muscle function), reduced inflammation, and glucose metabolism according to the Office of Dietary Supplements (ODS). However, there is one additional benefit that is less talked about — vitamin D and falls prevention for elderly and senior patients.

Vitamin D and falls prevention

In 2011, the Journal of Clinical Endocrinology & Metabolism published a meta-analysis of 26 trials involving a total of 45,782 participants in regard to vitamin D and falls prevention. It found that subjects who took both vitamin D and calcium had a reduced fall risk. This effect was even more pronounced when these individuals started their respective studies with a vitamin D deficiency.

A 2014 study found similar results. It was conducted on 404 patients at a memory clinic and found that seniors with lower vitamin D levels had poorer functional mobility. This was assessed by looking at their walking speeds and by using the Timed Up and Go (TUG) test. They also had poorer cognitive function. The findings were published in the journal Gerontology.

A 2016 case-control study in the Journal of Nutrition, Health & Aging adds that not only is vitamin D deficiency correlated with increased fall risk, but those with this type of deficiency also have more recurrent falls. Further, this vitamin appears to increase fall risk somewhat indirectly, by influencing conditions that predispose older persons to a fall versus inducing the fall itself.

The vitamin D-calcium connection

It should be noted that several of the studies looking at vitamin D’s effects on fall risk also involved the study subjects taking calcium. One was the previously mentioned 2011 study published in the Journal of Clinical Endocrinology & Metabolism. Another was a study published in Osteoporosis International.

This second study found that seniors taking calcium and vitamin D had a “significant decrease” in falls when compared to those taking calcium alone. Specifically, their number of falls decreased by 27% after one year of calcium and vitamin D supplementation. At 20 months, first falls for this group were decreased by 39%, partially by improving muscle function.

Vitamin D dosage impact on fall risk

Other studies have tried to ascertain whether a certain dosage of vitamin D may provide a greater benefit for reducing one’s fall risk. Findings have been somewhat unclear.

For example, a 2014 study in the Archives of Public Health reports that evidence supports an optimal vitamin D dosage of 800 IU per day for fall prevention. Another mentions a dosage range of between 800 IU and 1,000 IU daily for optimal effects, which this amount reducing falls by 16%.

Additional studies suggest that dosage might not be as relevant at higher doses. One was a 2016 study involving 200 subjects aged 70 and older who had a prior fall. This research involved participants taking either 24,000 IU of vitamin D3 or 60,000 IU, and it found that the actual dosage amount made no difference.

Published in JAMA Internal Medicine, this study concluded that there was no apparent fall-related benefit when choosing one amount over the other. This was even though those taking higher dosages had achieved blood level concentrations of at least 30 nanograms per milliliter (ng/mL).

A 2020 randomized trial also found that taking 1,000 IU or higher had no greater effect for reducing falls than those taking 200 IU. It further questioned whether taking 1,000 IU or more of vitamin D was safe.

Helping patients find the right vitamin D dosage

The ODS recommends that most adults get 15 mcg of vitamin D daily, which equates to 600 IU. Individuals 70 years of age and older should have slightly more, with a recommended daily allowance of 20 mcg or 800 IU.

Vitamin D can be found in foods such as milk, breakfast cereals, and fatty fish. Patients can also increase their vitamin D levels by spending a few minutes daily in the sun. Supplements are an additional way to increase one’s intake of this key nutrient.

Older adults aren’t the only ones at risk of low vitamin D levels. The concern of a deficiency is also higher for people with dark skin, those who have a medical condition that limits their ability to absorb fat (such as Crohn’s disease or celiac disease), and individuals who are obese or who’ve had gastric bypass surgery.

A blood test can determine a person’s vitamin D levels and provide guidance as to whether supplementation may be advised to address vitamin D and falls prevention.