Is fall prevention by vitamin D mediated by a change in postural or dynamic balance?

Bischoff-Ferrari et al., 2006 | Osteoporos Int | Rct

Citation

Bischoff-Ferrari H A, Conzelmann M, ... Allum J H J. Is fall prevention by vitamin D mediated by a change in postural or dynamic balance?. Osteoporos Int. 2006;17(5):656-63

Abstract

INTRODUCTION: The objectives were:(1) to validate a quantitative balance assessment method for fall risk prediction; (2) to investigate whether the effect of vitamin D and calcium on the risk of falling is mediated through postural or dynamic balance, as assessed by this method. MATERIALS AND METHODS: A secondary analysis of a double blind randomized controlled trial was employed, which included 64 institutionalized elderly women with complete balance assessment (age range: 65-97; mean 25-hydroxyvitamin D levels: 16.4 ng/ml (SD +/-9.9). Participants received 1,200 mg calcium plus 800 IU cholecalciferol (n=33) or 1,200 mg calcium (n=31) per day over a 3-month treatment period. Using an electronic device attached to the lower back of the participant, balance was assessed as the degree of trunk angular displacement and angular velocity during a postural task (standing on two legs, eyes open, for 20 s) and a dynamic task (get up from a standard height chair with arm rests, sit down and then stand up again and remain standing). RESULTS: It was found that both postural and dynamic balance independently and significantly predicted the rate of falling within the 3-month follow-up. Vitamin D plus calcium reduced the rate of falls by 60% [relative risk (RR)=0.40; 95% CI: 0.17, 0.94] if compared with calcium alone. Once postural and dynamic balance were added to the regression analysis, they both attenuated the effect of vitamin D plus calcium on the rate of falls. For postural balance, the RR changed by 22% from 0.40 to 0.62 if angular displacement was added to the model, and by 9% from 0.40 to 0.49 if angular velocity was added. For dynamic balance, it changed by 1% from 0.40 to 0.41 if angular displacement was added, and by 14% from 0.40 to 0.54 if angular velocity was added. DISCUSSION: Thus, balance assessment using trunk angular displacement is a valid method for the prediction of falls in older women. Of the observed 60% reduction in the rate of falls by vitamin D plus calcium supplementation compared with calcium alone, up to 22% of the treatment effect was explained by a change in postural balance and up to 14% by dynamic balance.

Key Findings

It was found that both postural and dynamic balance independently and significantly predicted the rate of falling within the 3-month follow-up. Vitamin D plus calcium reduced the rate of falls by 60% [relative risk (RR)=0.40; 95% CI: 0.17, 0.94] if compared with calcium alone. Once postural and dynamic balance were added to the regression analysis, they both attenuated the effect of vitamin D plus calcium on the rate of falls. For postural balance, the RR changed by 22% from 0.40 to 0.62 if angu

Outcomes Measured

• Requires manual extraction

Population

MeSH Terms

• Accidental Falls
• Aged
• Aged, 80 and over
• Calcium, Dietary
• Dietary Supplements
• Double-Blind Method
• Female
• Humans
• Postural Balance
• Switzerland
• Vitamin D

Evidence Classification

• Level: Rct
• Publication Types: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
• Vertical: vitamin-d-falls

Provenance

• PMID: 16508700
• DOI: (not available)
• PMCID: Not in PMC
• Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09