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. 2008 Oct 1;8(2):1–78.
Study Population Intervention, dose Follow-Up Outcomes measured Results
Gillespie: Cochrane Review (2003) (44)

  • Elderly

  • RCTs

  • Community-dwelling

 Vitamin D vs. control (2 studies) Varied Fallers, mean number of falls Results from meta-analysis

  1. Fallers: RR, 0.90 (0.71–1.13)

  2. Mean falls: mean difference, 0.10 (−0.71 to 0.91)
Gillespie (2003): Cochrane Review

  • Elderly

  • RCTs

  • Community-dwelling

 Psychotropic medication withdrawal (1 study – Campbell 1999) 44 weeks Fallers

  1. Fallers: HR, 0.34 (0.16–0.74)

  2. Note that one month after completion of study, 47% of medication withdrawal group had restarted taking psychotropic medication
Barr (2005) (172)

  • Women

  • Aged 70+

  • Intervention (screening + vitamin D/calcium)(N=726) vs. controls (N=1625)

  • In intervention group, screened for increased risk of hip fracture:

    broadband ultrasound attenuation (BUA) in lowest quartile of manufacturer normal range and/or presence of 2 or more clinical risk factors for hip fracture

  • Those with high risk were prescribed calcium and vitamin D supplement

 1 to 3 years (median follow-up 28.9 months) Fallers, number of people sustaining a fracture

  1. Proportion of fallers in active group lower (25.3%) than in control group (29.7%), but not significant

  2. Fracture: OR, 0.54 (0.33–0.87)
Bischoff (2006) (76)

  • Aged 65+

  • Intervention (vitamin D + calcium) (N=219) vs. placebo (N=226)

  • Intervention: cholecalciferol (vitamin D3; 700 IU/day) + calcium citrate malate (500 mg/day)

 3 years Faller (stratified by gender)

  1. Total sample: OR, 0.77 (0.51–1.15)

  2. Men: OR, 0.93 (0.50–1.72)

  3. Women: OR, 0.54 (0.30–0.97)
Dhesi (2004) (173)

  • Aged 65+

  • At least 1 fall in last 8 weeks

  • Intervention (N=70) vs. placebo (N=69)

  • Intervention included a single intramuscular injection of 600,000 IU of ergocalciferol (vitamin D)

  • Control: equivalent volume (2ml) of normal saline

 6 months Fallers, falls

  1. No difference in mean number of falls (0.39 vs. 0.24, P = .28)

  2. No difference in number of fallers (14 vs. 11, P = .52)
Dukas (2004) (174)

  • Aged 70+

  • Intervention (N=191) vs placebo (N=187)

  • Intervention received 1-µg capsules of alfacalcidol (vitamin D)

 36 weeks Fallers

  1. Overall: OR, 0.69 (0.41–1.16)

  2. Post-hoc subgroup of <512 mg and >512 mg daily calcium intake: <512 mg: OR, 1.00 (0.47–2.11) >512 mg: OR, 0.45 (0.21– 0.97)
Greenspan (2005) (175)

  • Women

  • Aged 65+

  • HRT (N=187) vs. placebo (N=186) Intervention (HRT):

  • Women with hysterectomy given conjugated equine estrogen (0.625 mg/day)

  • Remaining women received conjugated equine estrogen 0.625 mg/day) and medroxyprogesterone (2.5 mg/day)

 3 years Falls

  1. No difference in people who fell (50% intervention group vs. 51% in control), P = .92
Latham (2003) (176)

  • Frail

  • Mean age 79

  • Intervention (vitamin D) (N=108) vs. placebo (N=114)

  • Intervention: single oral dose of 6 1.25-mg calciferol (300,000 IU) or matching placebo tablets

 6 months Falls, time to first fall Falls Outcome:

  • RR, 1.12 (0.79–1.59) Time to first fall: HR, 1.14 (0.80–1.62)
Porthouse (2005) (177)

  • Women

  • Aged 70+

  • At least one self-reported risk factor for fracture (low weight, previous fracture, maternal history of hip fracture, smoker, poor/fair health)

  • Intervention (N=1321) vs. leaflet-only control (N=1993)

  • Intervention: nurse advice on reducing risk of fracture, 1000 mg calcium, 800 IU of vitamin D3, leaflet

  • Control: leaflet only

 Median follow-up 25 months All fractures, hip fractures, falls, fear of falling

  1. All fractures: OR, 1.01 (0.71– 1.43)

  2. Hip Fractures: OR, 0.75 (0.31–1.78)

  3. Falls: OR, 0.98 (0.79–1.20)
*

HR refers to hazard ratio; HRT, hormone replacement therapy; OR, odds ratio; RCT, randomized controlled trial; RR, relative risk.