To reduce their risk of debilitating falls that can crack a hip or spine, seniors who are unsteady on their feet should take vitamin D supplements and engage in regular exercise or physical therapy, a federal task force recommended on Monday. The US Preventive Services Task Force -- the same panel of experts that gave a thumbs down to PSA screening last week -- concluded that the latest evidence was strong enough to recommend these two measures.
The panel of experts recommended against other interventions such as vision correction, hip protectors, medication withdrawal, and protein supplementation because studies haven’t shown they reduce falling risk.
While vitamin D supplements have questionable benefits for a variety of health claims -- like warding off breast cancer or heart disease -- they have been established as helpful for preventing bone loss and falls in the elderly; it’s not clear why supplementation would help, but some studies suggest it may have something to do with improving balance by maintaining healthy bones.
“The USPSTF reviewed 9 trials of vitamin D supplementation and found an approximate 17 percent reduction in risk for falling during 6 to 36 months of follow-up,” according to the recommendations, which were published in the Annals of Internal Medicine. Just 10 people need to take vitamin D supplements to prevent one fall, which is better than for most drugs, including cholesterol-lowering statins to prevent heart attacks.
The experts specifically recommended that those deemed to be at increased risk of falling get 800 international units a day of Vitamin D from food or supplements starting at age 70, and 600 IU’s from age 50 to 70.
Seniors at increased risk should also get regular exercise or physical therapy, though the guidelines didn’t specify an exact definition of what sorts of activities -- such as balancing moves or strength training -- would be ideal. The task force based this recommendation on a review of 18 clinical trials showing that exercise or physical therapy reduced the risk of falling by 13 percent and that treating 16 people with 12 weeks of regimented activity could prevent one fall.
Since the studies varied in their exercise or physical therapy interventions, the task force left it up to doctors to decide specific treatments to recommend to individual patients.
Doctors will also have to determine which patients fall into the high-risk group, but the expert panel said a brief assessment to evaluate balance and gait or vision loss -- or a previous history of falls -- was just as good in most cases as a more assessment involving sophisticated testing.Deborah Kotz can be reached at firstname.lastname@example.org. Follow her on Twitter @debkotz2.