Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals
Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals
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DOI：
10.1007/s00198-008-0662-7
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发表时间：
2009-02-01
影响因子：
4
通讯作者：
Dobnig, H.
中科院分区：
文献类型：
--
作者：
Pfeifer, M.;Begerow, B.;Dobnig, H.
在242名社区居住的老年人中，补充1000 mg钙或1000 mg钙加维生素D导致受试者数量减少，第12个月时首次福尔斯下降27%，第20个月时下降39%。此外，肌肉功能的参数显着改善。维生素D和钙补充剂对老年人跌倒风险的有效性进行了有争议的讨论。需要使用福尔斯作为主要结局的随机对照试验。我们调查了钙和维生素D对社区老年男女的福尔斯和肌肉功能参数的长期影响，我们的研究人群包括242名通过广告和邮件列表招募的个体（平均[ +/- SD]年龄，77 +/- 4岁）。所有血清25-羟基维生素D（25[OH]D）水平均低于78 nmol/l。在12个月的治疗期内，个体以双盲方式接受1000 mg钙或1000 mg钙加800 IU维生素D/天，随后是8个月的无治疗但仍设盲的观察期。使用日记记录福尔斯。这项研究在德国的巴德皮尔蒙进行（纬度52 A度）和奥地利格拉兹与单钙相比，补充钙加维生素D导致在第12个月时首次福尔斯的受试者数量显著减少27（RR = 0.73; CI = 0.54-0.96），20个月时为39%（RR = 0.61; CI = 0.34-0.76）。关于次要终点，我们观察到股四头肌力量显著改善8%，身体摇摆减少28%，进行TUG试验所需时间减少11%。在减少社区居住老年人福尔斯次数和改善肌肉功能方面，钙和维生素D联合补充证明上级优于单独补充钙。
In 242 community-dwelling seniors, supplementation with either 1000 mg of calcium or 1000 mg of calcium plus vitamin D resulted in a decrease in the number of subjects with first falls of 27% at month 12 and 39% at month 20. Additionally, parameters of muscle function improved significantly.The efficacy of vitamin D and calcium supplementation on risk of falling in the elderly is discussed controversially. Randomized controlled trials using falls as primary outcome are needed. We investigated long-term effects of calcium and vitamin D on falls and parameters of muscle function in community-dwelling elderly women and men.Our study population consisted of 242 individuals recruited by advertisements and mailing lists (mean [ +/- SD] age, 77 +/- 4 years). All serum 25-hydroxyvitamin D (25[OH]D) levels were below 78 nmol/l. Individuals received in a double blinded fashion either 1000 mg of calcium or 1000 mg of calcium plus 800 IU of vitamin D per day over a treatment period of 12 months, which was followed by a treatment-free but still blinded observation period of 8 months. Falls were documented using diaries. The study took place in Bad Pyrmont, Germany (latitude 52A degrees) and Graz, Austria (latitude 46A degrees).Compared to calcium mono, supplementation with calcium plus vitamin D resulted in a significant decrease in the number of subjects with first falls of 27% at month 12 (RR = 0.73; CI = 0.54-0.96) and 39% at month 20 (RR = 0.61; CI = 0.34-0.76). Concerning secondary endpoints, we observed significant improvements in quadriceps strength of 8%, a decrease in body sway of 28%, and a decrease in time needed to perform the TUG test of 11%.Combined calcium and vitamin D supplementation proved superior to calcium alone in reducing the number of falls and improving muscle function in community-dwelling older individuals.