Association Between Vitamin D Dosing Regimen and Fall Prevention in Long-term Care Seniors

INTRODUCTION The effectiveness of vitamin D in reducing falls among long-term care (LTC) seniors remains nonconclusive. We reviewed how vitamin D dosing regimen could affect rate of fall and number of fallers among LTC seniors. METHODS We conducted a systematic literature review. Studies were selected by two independent reviewers based on study characteristics (age 75 or older), quality assessment (primary analysis randomized controlled trials), and outcome (rate of fall and number of fallers). Analyses of all trials following trials using daily standard dosage (800-1000 IU) only were performed to compare daily standard dosage with intermittent supratherapeutic dosage in fall prevention. RESULTS Seventy-nine studies were identified, with 28 selected by reviewers (kappa 0.98), and four RCT were conducted in LTC. Daily standard dosage provides greater reduction in rate of fall by 16%, which was statistically significant. However, reduction in number of fallers remained statistically insignificant even taking dosing regimen into account. CONCLUSIONS Daily standard dosage of vitamin D has greater benefits in reducing fall rate than that of intermittent supratherapeutic doses, but not in number of fallers. This could imply that vitamin D is useful in preventing fall recurrence rather than first fall. Prospective studies randomizing LTC seniors to different dosing regimens are warranted.