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Invited Commentary |

Vitamin D and Falls—Fitting New Data With Current Guidelines

Erin S. LeBlanc, MD, MPH1; Roger Chou, MD2,3
[+] Author Affiliations
1Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
2Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland
3Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland
JAMA Intern Med. 2015;175(5):712-713. doi:10.1001/jamainternmed.2015.0248.
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Vitamin D is of great interest to the medical and lay communities. Numerous observational studies (often cross-sectional) have examined the association between serum levels of 25-hydroxyvitamin D (25[OH]D) and various conditions. Low levels of 25(OH)D have been associated with increased risk of falls, fractures, cardiovascular disease, colorectal cancer, type 2 diabetes mellitus, depressed mood, cognitive decline, and mortality.1 However, such studies are subject to potential confounding and bias, and whether vitamin D supplementation reduces the risks of acquiring any of these conditions is less clear. Randomized clinical trials (RCTs) have not shown that vitamin D supplementation improves health, except in persons at high risk of falling, for which some studies14 have demonstrated a decreased risk of falls. Based on this evidence, the US Preventive Services Task Force5 (USPSTF) and the American Geriatric Society6 recommend vitamin D supplementation for persons who are at high risk of falls.

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Vitamin D Supplementation vs Placebo and Risk of Falls, Stratified by Baseline Vitamin D Level

The analysis was conducted with Review Manager 5.2 (http://review-manager.software.informer.com/5.2/). Data from Porthouse et al9 and Uusi-Rasi et al7 were obtained from the study authors, while data for the other trials were from published reports. Vitamin D levels were not measured in Porthouse et al,9 and the patients were recruited from primary care clinics. M-H indicates Mantel-Haenszel. To convert serum 25-hydroxyvitamin D level to nanomoles per liter, multiply by 2.496.

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