Vitamin D and the mechanisms, circumstances and consequences of falls in older adults: A case-control study

• Published in: The Journal of nutrition, health & aging health & aging, 2017-12, Vol.21 (10), p.1307-1313
• Main Authors: Duval, G. T., Paré, P.-Y., Gautier, J., Walrand, S., Dinomais, M., Annweiler, Cédric
• Format: Article
• Language: English
• Subjects: Accidental Falls - statistics & numerical data; Aged, 80 and over; Aging; Antihypertensives; Case-Control Studies; Falls; Female; France - epidemiology; Geriatrics/Gerontology; Humans; Hypotension, Orthostatic - epidemiology; Inpatients - statistics & numerical data; Life Sciences; Male; Medicine; Medicine & Public Health; Neurosciences; Nutrition; Older people; Prevalence; Primary Care Medicine; Quality of Life Research; Recurrence; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin deficiency
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-016-0857-0

Objectives To determine i) whether cases of elderly fallers had lower serum 25-hydroxyvitamin D (25OHD) concentration than controls without history of falls; and ii) whether serum 25OHD concentration was associated with specific mechanisms, circumstances and consequences of falls. Design Case-control study with a 1:2 ratio. Setting Geriatric ward of the University Hospital of Angers, France, between February 2012 and March 2014. Participants 216 inpatients (72 cases and 144 age- and gender-matched controls). Measurement Falls were defined as involuntary events causing the person to the ground or other lower level. The main mechanisms, circumstances and consequences of falls were identified using standardized questionnaires. Vitamin D deficiency was defined as serum 25OHD concentration ≤25nmol/L. Age, gender, body mass index, polypharmacy, use antihypertensive drugs, use psychoactive drugs, disability, cognitive performance, serum concentrations of parathyroid hormone, creatinine and albumin, and season of evaluation were used as potential confounders. Results 216 participants (72 cases and 144 controls) were included in the study. There was no between-group difference in the prevalence of vitamin D deficiency (P=0.176). After adjusting for confounding factors, vitamin D deficiency was positively associated with falls (OR=4.03, P=0.014). Finally, the fallers with vitamin D deficiency exhibited more often orthostatic hypotension (68.8% against 33.3%, P=0.039) and a history of recurrent falls (85% against 50%, P=0.002) than those without vitamin D deficiency. Conclusion This casecontrol study reported that vitamin D deficiency was associated with falls in older inpatients. There was a greater prevalence of orthostatic hypotension and of the reccurrence of falls among fallers with vitamin D deficiency, suggesting that vitamin D may influence the conditions predisposing to falls rather than the fall by itself.