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  • Administration of annual oral high-dose vitamin D to community-dwelling older women in autumn and winter months increases risk of falls and fractures

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Therapeutics
Randomised controlled trial
Administration of annual oral high-dose vitamin D to community-dwelling older women in autumn and winter months increases risk of falls and fractures
  1. Jacques P Brown
  1. Le Centre hospitalier universitaire de Québec-CHUL, Quebec City, Quebec, Canada
  1. Correspondence to Jacques P Brown
    S-763, 2705 Laurier boulevard, Quebec City, Quebec G1V 4G2, Canada; jacques.brown{at}crchul.ulaval.ca

https://doi.org/10.1136/ebm1122

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    Commentary on:

    1. Sanders KM,
    2. Stuart AL,
    3. Williamson EJ,
    4. et al
    . Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 2010;303:1815–22.
    OpenUrlCrossRefPubMedWeb of Science

    Context

    At latitudes above 35°N, where vitamin D insufficiency is common, winter sunlight does not contain sufficient ultraviolet B for endogenous vitamin D production, necessitating supplementation. Insufficient levels of vitamin D increase risks for falling and fracture.1 Randomised controlled trials investigating the efficacy of vitamin D supplementation for preventing falls and fractures have been unequivocal, complicated by different doses, dosing regimens, delivery methods, vitamin D types and populations.

    Methods

    Sanders and colleagues compared the rates of falls and fractures in 2256 community-dwelling women residing in southern Victoria, Australia (38°S latitude), randomly assigned to receive either an annual 500 000 IU oral dose of vitamin D3 or identical placebo each fall or winter. Women at high risk for fracture were entered into this single-centre, double-blinded trial and were followed for 3–5 years. Women were excluded if they were unable to provide consent or information regarding falls or fractures, resided in a high-level care facility, had high serum calcium (albumin-corrected >2.65 mmol/l) or creatinine (>150 µmol/l) or were currently taking ≥400 IU vitamin D per day, calcitriol or antifracture therapy. Treatment allocation was by an independent statistician.

    Baseline questionnaires detailed participants' ages, calcium intakes …

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    Footnotes

    • Competing interests None.