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Open AccessReview

Design Features of Randomized Clinical Trials of Vitamin D and Falls: A Systematic Review

by Olive Tang 1,2, Stephen P. Juraschek 1,2,3,4,5 and Lawrence J. Appel 1,2,3,4,5,*
Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 21287, USA
Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
Harvard Medical School, Boston, MA 02115, USA
Author to whom correspondence should be addressed.
Nutrients 2018, 10(8), 964;
Received: 1 June 2018 / Revised: 20 July 2018 / Accepted: 24 July 2018 / Published: 26 July 2018
Recent guidelines have advocated against the use of vitamin D supplementation as a means to prevent falls in older adults. However, meta-analyses of the available trials have reached divergent conclusions, and the key design features of these trials have not been well characterized. We conducted a systematic review of 30 randomized trials that reported the effects of vitamin D supplements on falls. Trials were identified by reviewing references of published meta-analyses and updated with a systematic PubMed search. We assessed three key design features: (1) recruitment of participants with vitamin D deficiency or insufficiency; (2) provision of daily oral vitamin D supplementation; and (3) utilization of highly sensitive at-event falls ascertainment. The trials enrolled a median of 337 (IQR: 170-1864) participants. Four (13.3%) trials restricted enrollment to those who were at least vitamin D insufficient, 18 (60.0%) included at least one arm providing daily supplementation, and 16 (53.3%) used at-event reporting. There was substantial heterogeneity between trials, and no single trial incorporated all three key design features. Rather than concluding that vitamin D is ineffective as a means to prevent falls, these findings suggest that existing trial evidence is insufficient to guide recommendations on the use of vitamin D supplements to prevent falls. View Full-Text
Keywords: vitamin D; falls prevention; trials vitamin D; falls prevention; trials
MDPI and ACS Style

Tang, O.; Juraschek, S.P.; Appel, L.J. Design Features of Randomized Clinical Trials of Vitamin D and Falls: A Systematic Review. Nutrients 2018, 10, 964.

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