Quality-of-life indicators and falls due to vitamin D deficiency
International Journal of General Medicine Dovepress
Objective: To determine whether the number of falls and quality-of-life indicators relate to serum levels of vitamin D, parathyroid hormone (PTH), and calcium levels.
Design: A prospective study.
Participants: Patients being admitted with a fall with or without sustaining a fragility fracture post fall.
Measurements: Measured frequency of falling, SF-12 questionnaire, serum concentrations of 25-hydroxyvitamin D, calcium, and PTH levels before and after treatment with vitamin D supplementation.
Results: The mean age (N=38) of the cohort was 80.2±12. In all, 76.3% of the cohort had sustained a fragility fracture after the fall. The cohort was vitamin D deficient with the pretreatment mean value of 24.2±17 nmol/L and posttreatment mean value of 99±40 nmol/L with a statistically significant mean difference of 74.7 nmol/L (confidence interval [CI] 61.27-88.3), P=0.001. The levels of calcium and PTH were statistically significant after treatment with a mean difference of 0.16 (CI 0.1-0.2), P=0.001, and 3.7 (CI -4.8 to -2.5), P=0.001, respectively. After treatment, the mean difference of physical component score (PCS) and mental component score for the whole cohort was 2.9 (CI -0.69 to 6.6), P=0.10, and 1.05 (CI -2.6 to 4.7), P=0.56, respectively. However, a subgroup analysis for cohort aged #70 years provided a statistically significant effect on PCS with a mean difference of 8.9 (CI 1.3-16.4), P=0.03, but a statistically insignificant improvement in mental component score with a mean difference of 6.0 (CI -17 to -5.0), P=0.20. However, a statistically significant improvement in PCS SF-12 was observed in patients #70 years of age 2.9 (1.3-16.4), P=0.03. The mean number of falls for the whole cohort pre- and posttreatment was 1.11 ±0.92 vs 0.97±0.99 (P=0.68), respectively.
Conclusion: Patients who had fallen and sustained fragility fracture had lower serum 25-dihydroxyvitamin D and higher serum PTH levels. Our study demonstrates that there is no statistically significant improvement in the number of falls after treatment with vitamin D. Overall, vitamin D levels improved significantly, this is despite quality-of-life indicators showing a mean increase in PCS but not a statistically significant improvement. However, statistically significant improvement in PCS was observed in group aged #70 years after vitamin D supplementation.
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PDF states that this trial used 60,000 IU weekly for 8 weeks
Expect that trial would have had great results if either of the following
1) Restored vitamin D levels first (60,000 daily for a week) then 8 weeks
2) Extended the time of the trial - say to 20 weeks (enough time for msucles to adapt)