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Richard L. Prince, MD; Nicole Austin, BSc; Amanda Devine, PhD; Ian M. Dick, PhD; David Bruce, MD; Kun Zhu, PhD

Arch Intern Med. 2008;168(1):103-108.

Background  Ergocalciferol (vitamin D₂) supplementation plays a role in fall prevention, but the effect in patients living in the community in sunny climates remains uncertain. We evaluated the effect of ergocalciferol and calcium citrate supplementation compared with calcium alone on the risk of falls in older women at high risk of falling.

Methods  A 1-year population-based, double-blind, randomized controlled trial of 302 community-dwelling ambulant older women aged 70 to 90 years living in Perth, Australia (latitude, 32°S), with a serum 25-hydroxyvitamin D concentration of less than 24.0 ng/mL and a history of falling in the previous year. Participants were randomized to receive ergocalciferol, 1000 IU/d, or identical placebo (hereinafter, ergocalciferol and control groups, respectively). Both groups received calcium citrate, 1000 mg/d. Fall data were collected every 6 weeks.

Results  Ergocalciferol therapy reduced the risk of having at least 1 fall over 1 year after adjustment for baseline height, which was significantly different between the 2 groups (ergocalciferol group, 53.0%; control group, 62.9%; odds ratio [OR], 0.61; 95% confidence interval [CI], 0.37-0.99). When those who fell were grouped by the season of first fall or the number of falls they had, ergocalciferol treatment reduced the risk of having the first fall in winter and spring (ergocalciferol group, 25.2%; control group, 35.8%; OR, 0.55; 95% CI, 0.32-0.96) but not in summer and autumn, and reduced the risk of having 1 fall (ergocalciferol group, 21.2%; control group, 33.8%; OR, 0.50; 95% CI, 0.28-0.88) but not multiple falls.

Conclusion  Patients with a history of falling and vitamin D insufficiency living in sunny climates benefit from ergocalciferol supplementation in addition to calcium, which is associated with a 19% reduction in the relative risk of falling, mostly in winter.

Trial Registration  actr.org.au Identifier: 12606000331538

Author Affiliations: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia (Drs Prince, Devine, Dick, Bruce, and Zhu and Ms Austin); Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia (Drs Prince, Dick, and Zhu); and School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth (Dr Devine).