(RxWiki News) When it comes to falls and fractures, an ounce of prevention really is worth a pound of cure. While supplements may improve older people's health, exercise remains the best way to boost strength and mobility and help prevent serious falls.
A recent study found that neither vitamin D supplements nor exercise reduced overall falls in older women. But women who did moderate exercise had fewer falls that led to fractures and other injuries.
This study, led by Kirsti Uusi-Rasi, PhD, of the UKK Institute for Health Promotion Research in Tampere, Finland, followed more than 400 home-dwelling older women for two years. These patients, aged 70 to 80, had at least one fall during the past year. Some of these women received vitamin D supplements. Others exercised for strength, balance and mobility.
Vitamin D and exercise did not reduce monthly reported falls, but the rate of serious falls and injured fallers dropped by more than half with strength and balance training, Dr. Uusi-Rasi and team found.
"Given the fact that fall risk [comes from many factors], exercise may be the most effective and feasible strategy for preventing injurious falls in community-dwelling older adults replete with vitamin D," Dr. Uusi-Rasi and team wrote. "Herein, vitamin D increased bone density slightly, and exercise improved physical functioning. While neither treatment reduced the rate of falling, injurious falls more than halved among exercisers with or without vitamin D."
Vitamin D may reduce bone loss, but only exercise improved mobility and balance, Dr. Uusi-Rasi and team said.
"Good physical condition may help prevent injuries during a fall, perhaps via better and safer landing techniques," these researchers wrote.
Although current US guidelines suggest vitamin D supplements for older adults at high risk of falls, the vitamin's role in reducing falls and fractures is unclear, Dr. Uusi-Rasi and team noted.
However, doctors should continue to recommend "the sunshine vitamin," said Erin S. LeBlanc, MD, of Kaiser Permanente Northwest, and Roger Chou, MD, of Oregon Health & Science University, both in Portland, in an editorial about this study.
"Given its low cost and low risk, vitamin D should remain in the physician's [toolbox] for fall prevention, at least until more data are available," Drs. LeBlanc and Chou wrote. "Taking a person's vitamin D status into account may be a useful clinical consideration. As more high-quality RCTs [randomized clinical trials] release their findings, we need to be ready to reevaluate the role that vitamin D has in maintaining health. However, the RCT by Uusi-Rasi and colleagues reminds us that the strongest and most consistent evidence for prevention of serious falls is exercise, which has multiple other health benefits."
The study and editorial were published March 23 in JAMA Internal Medicine.
The Academy of Finland, Ministry of Education and Culture, Competitive Research Fund of Pirkanmaa Hospital District and Juho Vainio Foundation funded this research. Dr. Uusi-Rasi and team disclosed no conflicts of interest.
