Falls: To D or Not to D—That Is Not the (Only) Question!
Authors: Bruce R. Troen
Journal: Annals of Internal Medicine (2020)

EditorialsFebruary 2021Falls: To D or Not to D—That Is Not the (Only) Question!Bruce R. Troen, MDBruce R. Troen, MDUniversity at Buffalo Jacobs School of Medicine and Biomedical Sciences and Veterans Affairs Western New York Healthcare System, Buffalo, New YorkAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-7609 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their current Annals article, Appel and colleagues (1) report the impact of vitamin D supplementation on falls in community-dwelling older adults. This interesting, innovative trial reinforces some of what we know, highlights what we still do not know, and underscores what we need to learn. Falls and their deleterious consequences remain a substantial risk for older adults and a huge challenge for health care teams. As many as one third of persons aged 65 years and older fall each year, and the consequences may be dire, leading to fractures and other injuries, hospitalization, nursing home admission, and even death. ...References1. Appel LJ, Michos ED, Mitchell CM, et al. The effects of four doses of vitamin D supplements on falls in older adults. A response-adaptive, randomized clinical trial. Ann Intern Med. 2021;174:145-56. doi:10.7326/M20-3812 Google Scholar2. Giustina A, Adler RA, Binkley N, et al. Consensus statement from 2nd International Conference on Controversies in Vitamin D. Rev Endocr Metab Disord. 2020;21:89-116. [PMID: 32180081] doi:10.1007/s11154-019-09532-w CrossrefMedlineGoogle Scholar3. Zheng Y, Zhu J, Zhou M, et al. Meta-analysis of long-term vitamin D supplementation on overall mortality. PLoS One. 2013;8:e82109. [PMID: 24349197] doi:10.1371/journal.pone.0082109 CrossrefMedlineGoogle Scholar4. Seldeen KL, Pang M, Leiker MM, et al. Chronic vitamin D insufficiency impairs physical performance in C57BL/6J mice. Aging (Albany NY). 2018;10:1338-55. [PMID: 29905532] doi:10.18632/aging.101471 CrossrefMedlineGoogle Scholar5. Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ, et al. Monthly high-dose vitamin D treatment for the prevention of functional decline: a randomized clinical trial. JAMA Intern Med. 2016;176:175-83. [PMID: 26747333] doi:10.1001/jamainternmed.2015.7148 CrossrefMedlineGoogle Scholar6. Burt LA, Billington EO, Rose MS, et al. Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength: a randomized clinical trial. JAMA. 2019;322:736-45. [PMID: 31454046] doi:10.1001/jama.2019.11889 CrossrefMedlineGoogle Scholar7. Smith LM, Gallagher JC, Suiter C. Medium doses of daily vitamin D decrease falls and higher doses of daily vitamin D3 increase falls: a randomized clinical trial. J Steroid Biochem Mol Biol. 2017;173:317-22. [PMID: 28323044] doi:10.1016/j.jsbmb.2017.03.015 CrossrefMedlineGoogle Scholar8. LeBoff MS, Murata EM, Cook NR, et al. VITamin D and OmegA-3 TriaL (VITAL): effects of vitamin D supplements on risk of falls in the US population. J Clin Endocrinol Metab. 2020;105. [PMID: 32492153] doi:10.1210/clinem/dgaa311 CrossrefMedlineGoogle Scholar9. Bhasin S, Gill TM, Reuben DB, et al; STRIDE Trial Investigators. A randomized trial of a multifactorial strategy to prevent serious fall injuries. N Engl J Med. 2020;383:129-40. [PMID: 32640131] doi:10.1056/NEJMoa2002183 CrossrefMedlineGoogle Scholar10. Lamb SE, Bruce J, Hossain A, et al; Prevention of Fall Injury Trial Study Group. Screening and intervention to prevent falls and fractures in older people. N Engl J Med. 2020;383:1848-59. [PMID: 33211928] doi:10.1056/NEJMoa2001500 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University at Buffalo Jacobs School of Medicine and Biomedical Sciences and Veterans Affairs Western New York Healthcare System, Buffalo, New YorkAcknowledgment: The author thanks Dr. Kenneth Seldeen for his valuable comments on this manuscript.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-7609.Corresponding Author: Bruce R. Troen, MD, University at Buffalo, 875 Ellicott Street, Buffalo CTRC - 8030 F, Buffalo, NY 14203; e-mail, [email protected]edu.This article was published at Annals.org on 8 December 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Effects of Four Doses of Vitamin D Supplements on Falls in Older Adults Lawrence J. Appel , Erin D. Michos , Christine M. Mitchell , Amanda L. Blackford , Alice L. Sternberg , Edgar R. Miller III , Stephen P. Juraschek , Jennifer A. Schrack , Sarah L. Szanton , Jeanne Charleston , Melissa Minotti , Sheriza N. Baksh , Robert H. Christenson , Josef Coresh , Lea T. Drye , Jack M. Guralnik , Rita R. Kalyani , Timothy B. Plante , David M. Shade , David L. Roth , James Tonascia , and Metrics February 2021Volume 174, Issue 2Page: 261-262KeywordsElderlyExercise therapyFallsHazard ratioHealth careHospitalizationsQuality of lifeSafetySafety studiesVitamin D ePublished: 8 December 2020 Issue Published: February 2021 Copyright & PermissionsCopyright © 2020 by 2020 American College of Physicians. All Rights Reserved.PDF downloadLoading ...