Effects of vitamin D and calcium on bone strength, balance and falls in elderly women

许多骨质疏松性骨折是由于骨脆性和福尔斯跌倒造成的。福尔斯和骨折都是澳大利亚巨大的公共卫生问题。福尔斯是65岁以上老年人受伤住院和死亡的主要原因。在1996年期间，近36，000人在跌倒后前往医院，其中5%导致骨折。跌倒相关住院的发生率随年龄呈指数级增长，85岁及以上的男性每年达到4%，女性每年达到7%。在社区中，每年约有三分之一的老年人跌倒。与男性相比，女性住院的可能性是男性的三倍，死于跌倒相关伤害的可能性是男性的一倍半。重要的是，女性骨折的风险增加，超过40%的50岁以上的女性会骨折。此前欧美的研究表明，钙的替代可能会提高骨强度，而维生素D可能会减少福尔斯。然而，这两种效应的分离从未被研究过。我们以前曾研究过在珀斯的大型教学医院急诊科就诊的老年跌倒妇女，并表明许多人缺乏钙和维生素D。我们正在进行一项短期随机对照试验，研究钙单独或钙与维生素D，以研究对骨强度的影响，如无创测量，平衡和福尔斯在这个高风险组的受试者。我们已经招募了100名受试者，其中6名受试者已经完成了6个月的评估。我们计划在接下来的12个月内招募剩余的200名受试者，并给予所有受试者一年的治疗。在这项研究结束时，我们应该能够为这一高危患者群体提供明确的治疗指南。

Many osteoporotic fractures occur as a result of bone fragility and falls. Both falls and fractures are huge public health problems in Australia. Falls are the leading cause of injury-related hospitalization and death in person older than 65 years of age. During 1996 almost 36,000 people attended a hospital after a fall and 5% of these resulted in fracturing a bone. The incidence of fall-related hospital admission increases exponentially with age, reaching 4% per annum for men and 7% per annum for women aged 85 years and older. In the community approximately one third of older people fall each year. Compared to men, women are three times more likely to be hospitalized or one and half times more likely to die from a fall-related injury. Importantly women have an increased risk of fracture and over 40% of women over the age of 50 will break a bone. Previous European and American studies suggest that calcium replacement may improve bone strength while vitamin D may reduce falls. However, the separation of these two effects has never been studied. We have previously studied elderly falling women who attended the Emergency Department of large teaching hospitals in Perth and have shown that many are calcium and vitamin D deficient. We are undertaking a short term randomized controlled trial of calcium alone or calcium with vitamin D, to study the effects on bone strength as measured non-invasively, balance and falls in this high risk group of subjects. We have already recruited 100 subjects and six subjects have completed their 6 months assessment. We plan to recruit the remaining 200 subjects during the following 12 months and give all subjects one year of treatment. At the end of this study we should be able to offer clear treatment guidelines for this high risk group of patients.