Abstract

SILVA, Anabela Barreto  and  BARBOSA, Maria João. Supplementation of vitamin D in prevention of falls and fractures in elderly: an evidence-based review. Rev Port Med Geral Fam [online]. 2020, vol.36, n.3, pp.277-287. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i3.12717.

Introduction: Falls and fractures are an important cause of hospitalization and mortality in elderly individuals, contributing significantly to their loss of autonomy. The role of vitamin D in improving musculoskeletal disorders in elderly patients in the prevention of falls and fractures is still controversial. Aim: To determine the evidence of the effect of vitamin D supplementation on the prevention of falls and fractures in the elderly. Data source: MEDLINE, The Cochrane Library, NGC, NICE, DARE, TRIP Database, USPSTF, AGS, and DGS. Methods: Research of studies published in the last 10 years (from February 1, 2009, to February 28, 2019) written in Portuguese and English using the terms MeSH ‘Vitamin D’, ‘Accidental Falls’, and ‘Fractures, Bone’. Evaluation of the quality of the studies and strength of recommendation was used in the Strength of Recommendation Taxonomy scale of the American Family Physician (SORT). Results: From the initial study, 514 articles were selected and 15 were selected because they met the defined inclusion criteria: six guidelines, eight systematic reviews (RS), and meta-analyses (MA) and one randomized clinical trial (RCT). Most guidelines and NOC advocate vitamin D supplementation in the prevention of falls and fractures in the elderly. However, the RS and MA analyzes show discordant results in demonstrating that vitamin D supplementation has no effect on falls and fractures in the elderly, particularly non-institutionalized. The effects may be greater in individuals with low baseline vitamin D levels. Conclusions: There is no benefit of vitamin supplementation in the prevention of falls and fractures (SORT B) in non-institutionalized elderly people without a deficit of 25(OH)D. Institutionalized elderly with a deficit of 25(OH)D should be supplemented with vitamin D alone or combined with calcium (SORT B). Supplementation of high doses of vitamin D and intermittently may have deleterious effects (SORT B).

Keywords : Vitamin D; Falls; Fractures; Elderly.

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