Background Vitamin D deficiency is common in elderly people because of the decreased capcity of Vitamin D synthesis caused by skin changes and decreased intake of vitamin D, decrease in the absorption by the intestines, lower activity of the enzyme 1 alpha-hydroxylase in the kidneys (1). Vitamin D deficiency in the elderly has been associated with muscle weakness, musculoskeletal pain, reduced balance control, increased falls and fall-related fractures (2). Vitamin D deficiency leads to a decrease in muscle strength, especially the proximal lower extremity, and thus causes an increase in the number of falls (2).
With aging, fall rates increase by %10 per decade and by the age of 65 years, one in three people falls each year and by the age of 80 years, one in two falls (3)
Objectives In this study, it was aimed to inquire if there is a relation between vitD levels and balance, risk of falls, functional mobility and lower extremity neuromuscular function among women 60 years-old and older.
Methods 200 females 60 or older, who were able to cooperate and stand independently were included in the study. They were grouped into two according to serum 25(OH)D levels as having low or normal vitD levels. They were accepted to have normal vitD levels if serum 25(OH)D was 50 nmol/L or above. Two groups were compared for balance, fall risk, functional mobility and lower extremity neuromuscular function. The short physical performance test was carried out for clinical balance test and at the same time for proximal lower extremity muscle strength and level of neuromuscular coordination. Hand grip strength was measured with a Jamar dynamometer. Fall risk was calculated by computerized static posturography by having patients stand in each position for 32 seconds, upright and holding onto nothing.
Results 200 subjects had a mean age of 66±5. 61.2% of the patients had serum 25(OH)D levels ≥50 nmol/L. The number of chronic diseases, body mass index, medication, daily calcium and vitamin D intake did not differ between the groups. Durations of exposure to the sun were higher in vitamin D normal group (p <0.05). Women with serum 25 (OH) D levels of 50 nmol / L or higher performed better on balance, walking speed and the chair sit to stand tests of short physical performance battery and results were statistically significant in all parameters (p<0.05). There were no differences in tetrax fall risk, bone densitometry, jamar grip strength, mini-mental test score between the groups (p>0,05).
Conclusions Although balance and lower extremity neuromuscular function were better in women with normal vitamin D levels, no statistically significant difference was obtained in risk of falling. A significant correlation was found between the risk of falling with using static posturography and short physical performance test. Randomized controlled trials are needed in this regard.
Kaya Ü, Karadağ SE, Akyüz G. Yaşlıarda Görülen D Vitamini Eksikliğinde Alfakalsidol Tedavisinin Düşme ve Denge Üzerine Etkileri. Türkiye FT Dergisi 2011:57:89-93.
Bischoff HA, Stahelin HB, Urscheler N et al. Muscle strength in the elderly: Its relation to vitamin D metabolites. Archives of physical medicine and rehabilitation 1999;80:54-58.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. The New England journal of medicine 1988;319:1701-7.
Disclosure of Interest None Declared
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