Skip to main content

Advertisement

Log in

Higher 1,25-dihydroxyvitamin D3 concentrations associated with lower fall rates in older community-dwelling women

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study was to examine the relationships of vitamin D supplementation and serum concentrations of vitamin D metabolites and parathyroid hormone (PTH) with neuromuscular function and falls in older community-dwelling women.

Methods

We examined these relationships using a 4-year prospective multi-center study among 9,526 community-dwelling women enrolled in the Study of Osteoporotic Fractures (median age: 70 years; interquartile range: 67–75) and a subset of 389 women (97%) out of 400 who were randomly selected from the entire cohort for serum measures. Measurements included: vitamin D supplementation, serum 25-hydroxyvitamin D3 [25(OH)D3], serum 1,25-dihydroxyvitamin D3 [1,25(OH) 2D3], and serum intact parathyroid hormone (iPTH); grip and quadriceps strength, chair-stand time, walking speed, reaction time, and balance-walk time (including changes in grip strength, chair-stand time, walking speed and balance-walk time over approximately 3.7 years); and incident fall rates (number of falls/woman-years).

Results

In 9,526 women, vitamin D supplementation was not associated with any measures of neuromuscular function, change in neuromuscular function, or fall rates (p>0.01 for all). In a subgroup of 389 women, there was a trend of higher 25(OH)D3 concentration with slightly weaker grip strength (p=0.007), and women in the fourth quartile of 1,25(OH)2D3 had a faster chair-stand time (p=0.017) than women in the first quartile; still, in general, concentrations of 25(OH)D3, 1,25(OH)2D3, and iPTH were not associated with either neuromuscular function or changes in neuromuscular function (p>0.05 for all). However, higher 1,25(OH)2D3 concentration was associated with lower fall rates (p=0.039).

Conclusions

Higher 1,25(OH)2D3 concentration is associated with a lower fall risk in older community-dwelling women, but vitamin D supplementation, and 25(OH)D3 and iPTH concentrations are not associated with either neuromuscular function or falls.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bischoff HA, Borchers M, Gudat F et al (2001) In situ detection of the 1,25- dihydroxyvitamin D3 receptor in human skeletal muscle tissue. Histochem J 33:19–24

    Article  PubMed  CAS  Google Scholar 

  2. Costa EM, Blau HM, Feldman D (1986) 1,25-Dihydroxyvitamin D3 receptors and hormonal responses in cloned human skeletal muscle cells. Endocrinology 119:2214–2220

    Article  PubMed  CAS  Google Scholar 

  3. Birge SJ, Haddad JG (1975) 25-Hydroxycholecalciferol Stimulation of Muscle Metabolism. J Clin Invest 56:1100–1107

    Article  PubMed  CAS  Google Scholar 

  4. Prabahala A, Garg R, Dandona P (2000) Severe myopathy associated with vitamin D deficiency in western New York. Arch Intern Med 160:1199–1203

    Article  Google Scholar 

  5. Rimaniol J-M, Authier F-J, Chariot P (1994) Muscle weakness in intensive care patients: initial manisfestation of vitamin D metabolites. Intensive Care Med 20:591–592

    Article  PubMed  CAS  Google Scholar 

  6. Delmont E, Roth S, Heudier P et al (2001) [Primary hyperparathyroidism, a differential diagnosis of motor neuron diseases.] Rev Med Interne 22:1253–1255

    Google Scholar 

  7. Gloth FM III, Gundberg CM, Hollis BW, Haddad JG, Tobin JD (1995) Vitamin D deficiency in homebound elderly persons. JAMA 274:1683–1686

    Article  PubMed  Google Scholar 

  8. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1988) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783

    Article  Google Scholar 

  9. Gloth FM, Smith CE, Hollis BW et al (1995) Functional improvement with vitamin D replishment in a cohort of frail, vitamin-D deficient older people. J Am Geriatr Soc 43:1269–1271

    PubMed  CAS  Google Scholar 

  10. Dhesi JK, Jackson SH, Bearne LM et al (2004) Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 33(6):589–595

    Article  PubMed  Google Scholar 

  11. Pfeifer M, Begerow B, Minne HW et al (2000) Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 15:1113–1118

    Article  PubMed  CAS  Google Scholar 

  12. Bischoff HA, Stahelin HB, Dick W et al (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18:343–351

    Article  PubMed  CAS  Google Scholar 

  13. Flicker L, Macinnis RJ, Stein MS, Scherer SC, Mead KE, Nowson CA, Thomas J, Lowndes C, Hopper JL, Wark JD (2005) Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc 53:1881–1888

    Article  PubMed  Google Scholar 

  14. Stein MS, Wark JD, Scherer SC et al (1999) Falls relate to vitamin D and parathyroid hormone in an Australian nursing home and hostel. J Am Geriatr Soc 47(10):1195–1201

    PubMed  CAS  Google Scholar 

  15. Sambrook PN, Chen JS, March LM et al (2003) Serum Parathyroid hormone predicts time to fall independent of vitamin D status in a frail elderly population. J Clin Endocrinol Metab 89:1572–1576

    Article  CAS  Google Scholar 

  16. Visser M, Deeg DJ, Lips P (2003) Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): The Longitudinal Aging study Amsterdam. J Clin Endocrinol Metab 88:5766–5772

    Article  PubMed  CAS  Google Scholar 

  17. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7:439–443

    Article  PubMed  CAS  Google Scholar 

  18. Vieth R, Ladak Y, Walfish P (2003) Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. J Clin Endocrinol Metab 88:185–191

    Article  PubMed  CAS  Google Scholar 

  19. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB (2004)Effect of vitamin D on falls. A meta-analysis. JAMA 291:1999–2006

    Article  PubMed  CAS  Google Scholar 

  20. Gallagher JC, Fowler SE, Detter JR (2001) Combination treatment with estrogen and calcitriol in the prevention of age-related bone loss. J Clin Endocrinol Metab 86:3618–3628

    Article  PubMed  CAS  Google Scholar 

  21. Dukas L, Bischoff HA, Lindpaintner LS et al (2004) Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 Mg daily. J Am Geriatr Soc 52:230–236

    Article  PubMed  Google Scholar 

  22. Kenny AM, Biskup B, Robbins B et al (2003) Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men. J Am Geriatr Soc 51:1762–1767

    Article  PubMed  Google Scholar 

  23. Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326:469–475

    Article  PubMed  CAS  Google Scholar 

  24. Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–773

    Article  PubMed  CAS  Google Scholar 

  25. Cummings SR, Browner WS, Bauer D et al (1998) Endogenous sex and calciotropic hormones and the risk of hip and vertebral fractures: the study of osteoporotic fractures. N Engl J Med 339:733–738

    Article  PubMed  CAS  Google Scholar 

  26. Nevitt MC, Cummings SR, Kidd S et al (1989) Risk factors for recurrent non-syncopal falls. JAMA 261:2663–2668

    Article  PubMed  CAS  Google Scholar 

  27. Cummings SR, Block G, McHenry K et al (1987) Evaluation of two food frequency methods of measuring dietary calcium intake. Am J Epidemiol 126:796–802

    PubMed  CAS  Google Scholar 

  28. Folstein MF, Robins LN, Helzer JE (1983) The Mini-Mental State Examination (letter). Arch Gen Psychiatry 40:812

    PubMed  CAS  Google Scholar 

  29. Yaffe K, Lui L-Y, Grady D et al (2000) Cognitive decline in women in relation to non-protein bound oestradiol concentrations. Lancet 356:708–712

    Article  PubMed  CAS  Google Scholar 

  30. Bailey IL, Lovie JE (1976) New design principles for visual acuity letter charts. Am J Optom Physiol Opt 53:740–745

    PubMed  CAS  Google Scholar 

  31. Lohman TG, Roche AF, Martorell R (1988) Anthropometric Standardization Reference Manual. 1st edn. Human Kinetics Books Champaign, Ill..

    Google Scholar 

  32. Chouchoud C, Pozet N, Labeeuw M et al (1999) Screening early renal failure: Cut-off values for serum creatinine as an indicator of renal impairment. Kid Int 55:1878–1884

    Article  Google Scholar 

  33. D’Agostino RB, Balanger A, D’Agostino RB Jr (1990) A suggestion for using powerful and informative tests of normality. Am Stat 44:316–321

    Article  Google Scholar 

  34. Liang K-Y, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73:13–22

    Article  Google Scholar 

  35. Gallagher JC (2004) The effects of calcitriol on falls and fractures and physical performance tests. J Steroid Biochem Mol Biol 89–90:497–501

    Article  PubMed  CAS  Google Scholar 

  36. Porthouse J, Cockayne S, King C, Saxon L, Steele E, Aspray T, Baverstock M, Birks Y, Dumville J, Francis R, Iglesias C, Puffer S, Sutcliffe A, Watt I, Torgerson DJ (2005) Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 330:1003–1008

    Article  PubMed  CAS  Google Scholar 

  37. O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S (1993) Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 137:342–354

    PubMed  CAS  Google Scholar 

  38. Latham NK, Anderson CS, Reid IR (2003) Effects of Vitamin D Supplementation on Strength, Physical Performance, and Falls in Older Persons: A Systematic Review. J Am Geriatr Soc 51:1219–1226

    Article  PubMed  Google Scholar 

  39. Slovik DM, Adams JS, Neer RM et al (1981) Deficient production of 1,25-dihydroxyvitamin D in elderly osteoporotic patients. N Engl J Med 305:372–374

    Article  PubMed  CAS  Google Scholar 

  40. Francis RM, Peacock M, Barkworth SA (1984) Renal impairment and its effects on calcium metabolism in elderly women. Age Ageing 13:1420

    Google Scholar 

  41. Castillo L, Tanaka Y, DeLuca HF et al (1977) The stimulation of 25-hydroxy-vitamin D1-alpha-hydroxylase by estrogen. Arch Biochem Biophys 179:211217

    Article  PubMed  CAS  Google Scholar 

  42. Nesbitt T, Drezner MK (1993) Insulin-like growth factor-I regulation of renal 25-hydroxyvitamin D-1-hydroxylase activity. Endocrinology 132:133–138

    Article  PubMed  CAS  Google Scholar 

  43. Dukas L, Schacht E, Stähelin HB (2002) Use of diuretics is associated with lower D-hormone serum levels but not with serum 25-hydroxyvitamin D in community-dwelling elderly men and women. Results from the baseline cross-sectional analyses of the Aims-Study. Osteoporos Int 13:S75

    Google Scholar 

  44. Oelzner P, Müller A, Deschner F et al (1997) Relationship between disease activity and serum levels of vitamin D metabolites and PTH in rheumatoid arthritis. Calcif Tissue Int 23:193198

    Google Scholar 

  45. Lau KHW, Baylink D (1999) Vitamin D therapy of osteoporosis: Plain vitamin D therapy versus active vitamin D analog (D-hormone) therapy. Calcif Tissue Int 65:295–306

    Article  PubMed  CAS  Google Scholar 

  46. Bischoff HA, Borchers M, Gudat F et al (2001) In situ detection of 1,25-dihydroxyvitamin D receptor in human skeletal muscle tissue. Histochem J 33:19–24

    Article  PubMed  CAS  Google Scholar 

  47. Bischoff-Ferrari HA, Borchers M, Gidat F et al (2004) Vitamin D Receptor Expression in human muscle tissue decreases with age. J Bone Miner Res 19:265–269

    Article  PubMed  CAS  Google Scholar 

  48. Ganz DA, Higashi T, Rubenstein LZ (2005) Monitoring Falls in Cohort Studies of Community-Dwelling Older People: Effect of the Recall Interval. J Am Geriatr Soc 53:2190–2194

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was funded by Grants AR35582, AR35583, AR44811, AG05407, and T32-AG00181 from the Public Health Service National Institutes of Health. The authors would like to thank Dr. Bess Dawson-Hughes for her critical review of this manuscript. None of the authors have any conflict of interests related to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K. A. Faulkner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Faulkner, K.A., Cauley, J.A., Zmuda, J.M. et al. Higher 1,25-dihydroxyvitamin D3 concentrations associated with lower fall rates in older community-dwelling women. Osteoporos Int 17, 1318–1328 (2006). https://doi.org/10.1007/s00198-006-0071-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-006-0071-8

Keywords

Navigation