DOI: https://doi.org/10.22141/2224-1507.10.1.2020.199721

Vitamin D deficiency as a risk factor of falls of elderly people

N.V. Dedukh, N.I. Dzerovych, M.A. Bystrytska

Abstract


Among elderly people, falls are a serious problem associated with a deterioration in the quality of life, fractures and increased mortality. Today, on the basis of scientific literature, a connection can be clearly traced between the deficiency of serum vitamin D and muscle weakness, cognitive impairment, that is, factors that lead to poorer balance and increase the risk of falling. The review analyzes the features of the effect of vitamin D on the structure and function of muscles, as well as evaluates the effectiveness of calcium and vitamin D intake on muscle strength and reduces the risk of falls in the elderly. Based on the literature data, the role of vitamin D in maintaining normal brain function has been proved, and the incidence of vitamin D deficiency in elderly patients with cognitive impairment has been estimated. It is concluded that data on the therapeutic efficacy of supplemental vitamin D supplementation in cognitive impairment are ambiguous. Issues requiring resolution are noted. First of all, the establishment of threshold values for vitamin D in serum, the need for additional studies to determine the best treatment methods, including the dose of vitamin D and the duration of treatment. The most controversial issue is the use of high doses of vitamin D. Based on the analysis, most researchers consider it unreasonable to use high doses of vitamin D in preventing the frequency and risk of falls, and in general, their negative impact on human health. There is evidence that vitamin D is most effective in combination with calcium. However, despite the growing number of scientific studies on the association of vitamin D with falls, the role and importance of vitamin D in this process has not been conclusively established.


Keywords


falls; vitamin D; deficiency; supplementation; muscles; cognitive impairment

Full Text:

PDF

References


Wacker M, Holick MF. Vitamin D - effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5(1):111–148. https://doi.org/10.3390/nu5010111.

Chen H, Liu Y, Huang G, Zhu J, Feng W, He J. Association between vitamin D status and cognitive impairment in acute ischemic stroke patients: a prospective cohort study. Clin Interv Aging. 2018;13:2503–2509. https://doi.org/10.2147/cia.s187142.

DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013;39(5):458–484. https://doi.org/10.1111/nan.12020.

Deluca HF. History of the discovery of vitamin D and its active metabolites. Bonekey Rep. 2014;3:479. https://doi.org/10.1038/bonekey.2013.213.

Remelli F, Vitali A, Zurlo A, Volpato S. Vitamin D Deficiency and Sarcopenia in Older Persons. Nutrients. 2019;11(12):2861. https://doi.org/10.3390/nu11122861.

Flicker L, Mead K, MacInnis RJ, et al. Serum vitamin D and falls in older women in residential care in Australia. J Am Geriatr Soc. 2003;51(11):1533–1538. https://doi.org/10.1046/j.1532-5415.2003.51510.x.

Flicker L. Vitamin D and the endocrinology of ageing. Current Opinion in Endocrine and Metabolic Research. 2019;5:7–10. https://doi.org/10.1016/j.coemr.2018.12.001.

Gunton JE, Girgis CM. Vitamin D and muscle. Bone Rep. 2018;8:163–167. https://doi.org/10.1016/j.bonr.2018.04.004.

Wicherts IS, van Schoor NM, Boeke AJ, et al. Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab. 2007;92(6):2058–2065. https://doi.org/10.1210/jc.2006-1525.

Murad MH, Elamin KB, Abu Elnour NO, et al. Clinical review: The effect of vitamin D on falls: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2011;96(10):2997–3006. https://doi.org/10.1210/jc.2011-1193.

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–281. https://doi.org/10.1056/nejmra070553.

Flicker L, MacInnis RJ, Stein MS, et al. Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc. 2005;53(11):1881–1888. https://doi.org/10.1111/j.1532-5415.2005.00468.x.

Bischoff HA, Stähelin HB, Dick W, et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003;18(2):343–351. https://doi.org/10.1359/jbmr.2003.18.2.343.

Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H. Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporos Int. 2009;20(2):315–322. https://doi.org/10.1007/s00198-008-0662-7.

Kärkkäinen MK, Tuppurainen M, Salovaara K, et al. Does daily vitamin D 800 IU and calcium 1000 mg supplementation decrease the risk of falling in ambulatory women aged 65-71 years? A 3-year randomized population-based trial (OSTPRE-FPS). Maturitas. 2010;65(4):359–365. https://doi.org/10.1016/j.maturitas.2009.12.018.

Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;(9):CD007146. https://doi.org/10.1002/14651858.cd007146.pub3.

Cameron ID, Dyer SM, Panagoda CE, et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev. 2018;9(9):CD005465. https://doi.org/10.1002/14651858.cd005465.pub4.

Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc. 2007;55(2):234–239. https://doi.org/10.1111/j.1532-5415.2007.01048.x.

Chakhtoura M, Chamoun N, Rahme M, Fuleihan GE. Impact of vitamin D supplementation on falls and fractures-A critical appraisal of the quality of the evidence and an overview of the available guidelines. Bone. 2020;131:115112. https://doi.org/10.1016/j.bone.2019.115112.

Grant AM, Avenell A, Campbell MK, et al. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet. 2005;365(9471):1621–1628. https://doi.org/10.1016/s0140-6736(05)63013-9.

Khaw KT, Stewart AW, Waayer D, et al. Effect of monthly high-dose vitamin D supplementation on falls and non-vertebral fractures: secondary and post-hoc outcomes from the randomised, double-blind, placebo-controlled ViDA trial. Lancet Diabetes Endocrinol. 2017;5(6):438–447. https://doi.org/10.1016/s2213-8587(17)30103-1.

Pike JW. Closing in on Vitamin D Action in Skeletal Muscle: Early Activity in Muscle Stem Cells?. Endocrinology. 2016;157(1):48–51. https://doi.org/10.1210/en.2015-2009.

Campbell WW, Johnson CA, McCabe GP, Carnell NS. Dietary protein requirements of younger and older adults. Am J Clin Nutr. 2008;88(5):1322–1329. https://doi.org/10.3945/ajcn.2008.26072.

Endo I, Inoue D, Mitsui T, et al. Deletion of vitamin D receptor gene in mice results in abnormal skeletal muscle development with deregulated expression of myoregulatory transcription factors. Endocrinology. 2003;144(12):5138–5144. https://doi.org/10.1210/en.2003-0502.

Granic A, Hill TR, Davies K, et al. Vitamin D Status, Muscle Strength and Physical Performance Decline in Very Old Adults: A Prospective Study. Nutrients. 2017;9(4):379. https://doi.org/10.3390/nu9040379.

Wintermeyer E, Ihle C, Ehnert S, et al. Crucial Role of Vitamin D in the Musculoskeletal System. Nutrients. 2016;8(6):319. https://doi.org/10.3390/nu8060319.

Hassan-Smith ZK, Jenkinson C, Smith DJ, et al. 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 exert distinct effects on human skeletal muscle function and gene expression. PLoS One. 2017;12(2):e0170665. doi:10.1371/journal.pone.0170665.

Hangelbroek R, Vaes AMM, Boekschoten MV. No effect of 25-hydroxyvitamin D supplementation on the skeletal muscle transcriptome in vitamin D deficient frail older adults. BMC Geriatrics 2019;19(1). https://doi.org/10.1371/journal.pone.0170665.

Girgis CM, Clifton-Bligh RJ, Hamrick MW, Holick MF, Gunton JE. The roles of vitamin D in skeletal muscle: form, function, and metabolism. Endocr Rev. 2013;34(1):33–83. https://doi.org/10.1210/er.2012-1012.

Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339:b3692. https://doi.org/10.1136/bmj.b3692.

Cummings SR, Kiel DP, Black DM. Vitamin D Supplementation and Increased Risk of Falling: A Cautionary Tale of Vitamin Supplements Retold [published correction appears in JAMA Intern Med. 2016 Mar;176(3):417]. JAMA Intern Med. 2016;176(2):171–172. https://doi.org/10.1001/jamainternmed.2015.7568.

Huo YR, Suriyaarachchi P, Gomez F, et al. Phenotype of osteosarcopenia in older individuals with a history of falling. J Am Med Dir Assoc. 2015;16(4):290–295. https://doi.org/10.1016/j.jamda.2014.10.018.

Kim MK, Baek KH, Song KH, et al. Vitamin D deficiency is associated with sarcopenia in older Koreans, regardless of obesity: the Fourth Korea National Health and Nutrition Examination Surveys (KNHANES IV) 2009. J Clin Endocrinol Metab. 2011;96(10):3250–3256. https://doi.org/10.1210/jc.2011-1602.

Pérez-López FR. Vitamin D and its implications for musculoskeletal health in women: an update. Maturitas. 2007;58(2):117–137. https://doi.org/10.1016/j.maturitas.2007.05.002.

Suresh E, Wimalaratna S. Proximal myopathy: diagnostic approach and initial management. Postgrad Med J. 2013;89(1054):470–477. https://doi.org/10.1136/postgradmedj-2013-131752.

Houston DK, Cesari M, Ferrucci L, et al. Association between vitamin D status and physical performance: the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2007;62(4):440–446. https://doi.org/10.1093/gerona/62.4.440.

Visser M, Deeg DJ, Lips P; Longitudinal Aging Study Amsterdam. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab. 2003;88(12):5766–5772. https://doi.org/10.1210/jc.2003-030604.

Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle. 2016;7(5):512–514. https://doi.org/10.1002/jcsm.12147.

Budui SL, Rossi AP, Zamboni M. The pathogenetic bases of sarcopenia. Clin Cases Miner Bone Metab. 2015;12(1):22–26. https://doi.org/10.11138/ccmbm/2015.12.1.022.

Faje A, Klibanski A. Body composition and skeletal health: too heavy? Too thin?. Curr Osteoporos Rep. 2012;10(3):208–216. https://doi.org/10.1007/s11914-012-0106-3.

Beaudart C, Buckinx F, Rabenda V, et al. The effects of vitamin D on skeletal muscle strength, muscle mass, and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab. 2014;99(11):4336–4345. https://doi.org/10.1210/jc.2014-1742.

Rejnmark L. Effects of vitamin d on muscle function and performance: a review of evidence from randomized controlled trials. Ther Adv Chronic Dis. 2011;2(1):25–37. https://doi.org/10.1177/2040622310381934.

Park S, Ham JO, Lee BK. A positive association of vitamin D deficiency and sarcopenia in 50 year old women, but not men. Clin Nutr. 2014;33(5):900–905. https://doi.org/10.1016/j.clnu.2013.09.016.

Iolascon G, Moretti A, de Sire A, Calafiore D, Gimigliano F. Effectiveness of Calcifediol in Improving Muscle Function in Post-Menopausal Women: A Prospective Cohort Study. Adv Ther. 2017;34(3):744–752. https://doi.org/10.1007/s12325-017-0492-0.

Mokrysheva NG, Krupinova JA, Volodicheva VL, Mirnaya SS, Melnichenko GA. A view at sarcopenia by endocrinologist. Obesity and metabolism. 2018;15(3):21–27. https://doi.org/10.14341/omet9792. (in Russian).

Brouwer-Brolsma EM, Bischoff-Ferrari HA, Bouillon R, et al. Vitamin D: do we get enough? A discussion between vitamin D experts in order to make a step towards the harmonisation of dietary reference intakes for vitamin D across Europe. Osteoporos Int. 2013;24(5):1567–1577. https://doi.org/10.1007/s00198-012-2231-3.

Bischoff-Ferrari HA. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes. Adv Exp Med Biol. 2014;810:500–525. https://doi.org/10.1007/978-1-4939-0437-2_28.

Roseveare D. World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2018): Poster Abstracts. Osteoporos Int. 2018;29(Suppl 1):149–565. https://doi.org/10.1007/s00198-018-4465-1.

Garcion E, Wion-Barbot N, Montero-Menei CN, Berger F, Wion D. New clues about vitamin D functions in the nervous system. Trends Endocrinol Metab. 2002;13(3):100–105. https://doi.org/10.1016/s1043-2760(01)00547-1.

Harms LR, Burne TH, Eyles DW, McGrath JJ. Vitamin D and the brain. Best Pract Res Clin Endocrinol Metab. 2011;25(4):657–669. https://doi.org/10.1016/j.beem.2011.05.009.

Gold J, Shoaib A, Gorthy G, Grossberg GT. The role of vitamin D in cognitive disorders in older adults. US Neurology. 2018;14(1):41–46. https://doi.org/10.17925/USN.2018.14.1.41.

Muir SW, Gopaul K, Montero Odasso MM. The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. Age Ageing. 2012;41(3):299–308. https://doi.org/10.1093/ageing/afs012.

Ates Bulut E, Soysal P, Yavuz I, Kocyigit SE, Isik AT. Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study [published online ahead of print, 2019 Jan 1]. Am J Alzheimers Dis Other Demen. 2019;1533317518822274. https://doi.org/10.1177/1533317518822274.

A Anjum I, Jaffery SS, Fayyaz M, Samoo Z, Anjum S. The Role of Vitamin D in Brain Health: A Mini Literature Review. Cureus. 2018;10(7):e2960. https://doi.org/10.7759/cureus.2960.

Bikle DD. Vitamin D: Newer Concepts of Its Metabolism and Function at the Basic and Clinical Level. J Endocr Soc. 2020;4(2):bvz038. https://doi.org/10.1210/jendso/bvz038.

Pludowski P, Holick MF, Grant WB, et al. Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol. 2018;175:125–135. https://doi.org/10.1016/j.jsbmb.2017.01.021.

Rizzoli R, Boonen S, Brandi ML, et al. Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin. 2013;29(4):305–313. https://doi.org/10.1185/03007995.2013.766162.

Reid IR. Vitamin D Effect on Bone Mineral Density and Fractures. Endocrinol Metab Clin North Am. 2017;46(4):935–945. https://doi.org/10.1016/j.ecl.2017.07.005.

Burt LA, Billington EO, Rose MS, Raymond DA, Hanley DA, Boyd SK. Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength: A Randomized Clinical Trial. JAMA. 2019;322(8):736–745. https://doi.org/10.1001/jama.2019.11889.

Latham NK, Anderson CS, Lee A, et al. A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc. 2003;51(3):291–299. https://doi.org/10.1046/j.1532-5415.2003.51101.x.

Sanders KM, Stuart AL, Williamson EJ, et al. Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA. 2010;303(18):1815–1822. https://doi.org/10.1001/jama.2010.594.

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(2):175–183. https://doi.org/10.1001/jamainternmed.2015.7148.






Copyright (c) 2020 N.V. Dedukh, N.I. Dzerovych, M.A. Bystrytska

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2020

 

   Seo анализ сайта