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Vitamin D and Falls in Older African American Women: The PODA Randomized Clinical Trial
Author(s) -
Aloia John F.,
Rubinova Rakhil,
Fazzari Melissa,
Islam Shahidul,
Mikhail Mageda,
Ragolia Louis
Publication year - 2019
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.15760
Subject(s) - medicine , placebo , vitamin d and neurology , randomized controlled trial , population , vitamin , osteoporosis , vitamin d deficiency , physical therapy , alternative medicine , environmental health , pathology
Background Limited information is available on the influence of vitamin D on falls in older high‐functioning black American women. Endocrine Society guidelines propose serum 25(OH)D levels over 30 ng/mL. Objective To determine if maintenance of serum 25(OH)D above 30 ng/mL protects against falls. Design The Physical Performance, Osteoporosis and Vitamin D in African American Women (PODA) trial had a prospective, randomized, placebo‐controlled, double‐dummy design with two arms: one with placebo and one with vitamin D 3 adjusted to maintain serum 25(OH)D above 30 ng/mL. The primary outcomes were the prevention of bone loss and the decline in physical performance. Patients The target population was healthy black women older than 60 years with serum 25(OH)D between 8 and 26 ng/mL. The trial was 3 years in duration with a falls questionnaire administered every 3 months. A total of 260 women entered the study, and 184 completed the 3 years. Mean age was 68.2 years. Setting Research center in an academic health center. Main Outcomes Measure Prevention of falls. Intervention Participants were randomly assigned to placebo or active vitamin D. Vitamin D 3 dose was adjusted to maintain serum 25(OH)D above 30 ng/mL in the active group using a double‐dummy design. Results Baseline 25(OH)D was 22 ng/mL. Mean serum 25(OH)D reached 47 ng/mL in the active group compared with 21 ng/mL in the placebo group. There were 14.2% falls in the previous year recalled at baseline. During the study, 46% reported falling in the treatment group compared with 47% in the placebo group. There was no association of serum 25(OH)D or vitamin D dose with the risk of falling. Conclusions There is no benefit of maintaining serum 25(OH)D above 30 ng/mL compared with the Institute of Medicine recommendation (20 ng/mL) in preventing falls in healthy older black American women. J Am Geriatr Soc 67:1043–1049, 2019.