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Vitamin D Status in Relation to One-Year Risk of Recurrent Falling in Older Men and Women

Institute of Health Sciences (M.B.S., R.M.v.D., M.V.), Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; EMGO Institute (M.B.S., N.M.v.S., M.V., P.L.) and Department of Endocrinology (P.L.), Vrije Universiteit Medical Center, 1081 BT Amsterdam, The Netherlands; Department of Public Health (S.M.F.P.), Erasmus Medical Center Rotterdam, 3000 DR Rotterdam, The Netherlands; and Department of Nutrition (R.M.v.D.), Harvard School of Public Health, Boston, Massachusetts 02115

Address all correspondence and requests for reprints to: Marieke B. Snijder, Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands. E-mail: marieke.snijder{at}falw.vu.nl.

Background: Falls frequently occur in the elderly and are a major cause of morbidity and mortality.

Objective: The objective of the study was to prospectively investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and risk of recurrent falling in older men and women.

Design: This was a prospective cohort study.

Setting: An age- and sex-stratified random sample of the Dutch older population was determined.

Subjects: Subjects included 1231 men and women (aged 65 yr and older) participating in the Longitudinal Aging Study Amsterdam.

Measurements: Baseline serum 25(OH)D was determined by a competitive protein binding assay. During 1 yr, falls were prospectively recorded by means of a fall calendar.

Results: Low 25(OH)D (<10 ng/ml) was associated with an increased risk of falling. After adjustment for age, sex, education level, region, season, physical activity, smoking, and alcohol intake, the odds ratios (95% confidence interval) were 1.78 (1.06–2.99) for subjects who experienced two falls or more as compared with those who did not fall or fell once and 2.23 (1.17–4.25) for subjects who fell three or more times as compared with those who fell two times or less. There was a statistically significant effect modification by age, and stratified analyses (<75 and 75 yr) showed that the associations were particularly strong in the younger age group; the odds ratios (95% confidence interval) were 5.21 (2.03–13.40) for two falls or more and 4.96 (1.52–16.23) for three falls or more.

Conclusions: Poor vitamin D status is independently associated with an increased risk of falling in the elderly, particularly in those aged 65–75 yr.

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