Studying vitamin D’s effect on fall risk

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Carol Sorgen

Falls are the leading cause of injury and accidental death in adults over the age of 65. Every year, more than 33 percent of seniors fall in the United States. Every 15 seconds, an older adult is treated in an emergency room for an injury related to a fall.

Clutter, inappropriate footwear, poor balance, distractions and tripping hazards can all contribute to a stumble or fall, potentially leading to serious injury, fractured bones, long-term disability and even death. At a minimum, falls — and the fear of falling — can cause decreased independence.

How Vitamin D can help

Johns Hopkins University is conducting a study to determine whether vitamin D supplements might substantially reduce the risk of falls in older adults.

Vitamin D is necessary for bone development and maintenance throughout life. It not only helps the body absorb calcium and slow down bone mineral loss, vitamin D also affects muscle.

According to the International Osteoporosis Foundation (IOF), research has shown that vitamin D can improve muscle strength and function, and as a result, reduce the risk of falls and fractures by about 20 percent.

Our bodies manufacture vitamin D when our skin is exposed to sunlight. Older people, however, are prone to Vitamin D deficiency, in part because their skin is not as efficient in producing vitamin D as it was when they were younger, and in part because many older adults are housebound or don’t go outdoors frequently.

The IOF has recommended that adults aged 60 or older take 800 to 1000 International Units (IU) of vitamin D supplements each day to reduce the risk of falls and fractures.

The principal objective of the STURDY (“Study to Understand Fall Reduction and Vitamin D in You”) TRIAL is to determine which of four doses of vitamin D pills is best at preventing falls in older adults — 200 IU/day, 1,000 IU/day, 2,000 IU/day or 4,000 IU/day.

Who can participate?

You may be eligible to participate in this study if you are 70 years of age or older and have low to low-normal vitamin D levels.

Participants must be at a high risk for falling, answering “yes” to at least one of the following questions:

1. Have you fallen and hurt yourself in the past year?

2. Have you fallen two or more times in the past year?

3. Are you afraid that you might fall because of balance or walking problems?

4. Do you have difficulty maintaining your balance when bathing, dressing, or getting in and out of a chair?

5. Do you use a cane, walker or other device when walking inside or outside your home?

In Stage 1 of the trial, participants will be randomly assigned to one of the four vitamin D3 doses. Participants will take their assigned pills for two years, or until the study ends, whichever comes first (estimated completion date is March 31, 2020).

At that point, if a best dose has been determined, participants will be randomized in Stage 2 of the trial to take 200 IU/day or the best dose, and all participants will continue to be followed. The investigators anticipate enrolling approximately 1,200 participants over the entire length of the study.

Outcomes measured will include the time to first fall over two years, gait speed, fall rates, types of falls, balance, muscle strength, frailty and physical performance.

Those taking part in the study will be expected to complete five visits to the clinic at  ProHealth Center Research Site, 1849 Gwynn Oak Ave., over two years, take a vitamin D pill every day, notify the study coordinator if a fall occurs, answer questions over the phone, and do balance and walking tests.

Medical tests are provided free of cost, and participants may earn up to $120 over the course of two years.

For more information, call (410) 281-1600 or visit www.sturdytrial.org.