Jack M Guralnik1, Alice L Sternberg2, Christine M Mitchell2, Amanda L Blackford3, Jennifer Schrack2, Amal A Wanigatunga2, Erin Michos4, Stephen P Juraschek5, Sarah Szanton6, Rita Kalyani7, Yurun Cai2, Lawrence J Appel8. 1. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. 3. Oncology Biostatistics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 4. Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 5. Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. 6. School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA. 7. Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 8. Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University , Baltimore, Maryland, USA.
Abstract
BACKGROUND: Studies of the relationship between vitamin D and physical functioning have had inconsistent results. METHODS: Physical functioning measures were collected for up to 2 years during a 2-stage, Bayesian, response-adaptive, randomized trial of 4 doses of vitamin D3 supplementation (200 [control], 1 000, 2 000, and 4 000 IU/day) to prevent falls. Two community-based research units enrolled adults aged ≥70 years, with elevated fall risk and serum 25-hydroxyvitamin D level of 10-29 ng/mL. The Pooled Higher Doses (PHD) group (≥1 000 IU/day, n = 349) was compared to the control group (n = 339) on changes in Short Physical Performance Battery (SPPB) score and its component tests, Timed Up-and-Go (TUG) test, 6-minute walk distance, and grip strength. RESULTS: The trial enrolled 688 participants. Mean age was 77.2 years, 56.4% were male, 79.7% White, and 18.2% Black. While the PHD and control groups both lost function over time on most outcomes, the 2 groups did not show differential change overall on any outcome. Incidence of transitioning to poor functioning on gait speed, SPPB score, or TUG test did not differ by dose group. CONCLUSION: In older persons with low serum 25-hydroxyvitamin D level and elevated fall risk, high-dose vitamin D supplementation, ≥1 000 IU/day, did not improve measures of physical function compared to 200 IU/day. CLINICAL TRIAL REGISTRATION: NCT02166333.
BACKGROUND: Studies of the relationship between vitamin D and physical functioning have had inconsistent results. METHODS: Physical functioning measures were collected for up to 2 years during a 2-stage, Bayesian, response-adaptive, randomized trial of 4 doses of vitamin D3 supplementation (200 [control], 1 000, 2 000, and 4 000 IU/day) to prevent falls. Two community-based research units enrolled adults aged ≥70 years, with elevated fall risk and serum 25-hydroxyvitamin D level of 10-29 ng/mL. The Pooled Higher Doses (PHD) group (≥1 000 IU/day, n = 349) was compared to the control group (n = 339) on changes in Short Physical Performance Battery (SPPB) score and its component tests, Timed Up-and-Go (TUG) test, 6-minute walk distance, and grip strength. RESULTS: The trial enrolled 688 participants. Mean age was 77.2 years, 56.4% were male, 79.7% White, and 18.2% Black. While the PHD and control groups both lost function over time on most outcomes, the 2 groups did not show differential change overall on any outcome. Incidence of transitioning to poor functioning on gait speed, SPPB score, or TUG test did not differ by dose group. CONCLUSION: In older persons with low serum 25-hydroxyvitamin D level and elevated fall risk, high-dose vitamin D supplementation, ≥1 000 IU/day, did not improve measures of physical function compared to 200 IU/day. CLINICAL TRIAL REGISTRATION: NCT02166333.
Authors: Erin D Michos; Christine M Mitchell; Edgar R Miller; Alice L Sternberg; Stephen P Juraschek; Jennifer A Schrack; Sarah L Szanton; Jeremy D Walston; Rita R Kalyani; Timothy B Plante; Robert H Christenson; Dave Shade; James Tonascia; David L Roth; Lawrence J Appel Journal: Contemp Clin Trials Date: 2018-08-20 Impact factor: 2.226
Authors: Michael F Holick; Neil C Binkley; Heike A Bischoff-Ferrari; Catherine M Gordon; David A Hanley; Robert P Heaney; M Hassan Murad; Connie M Weaver Journal: J Clin Endocrinol Metab Date: 2011-06-06 Impact factor: 5.958
Authors: G H Guyatt; M J Sullivan; P J Thompson; E L Fallen; S O Pugsley; D W Taylor; L B Berman Journal: Can Med Assoc J Date: 1985-04-15 Impact factor: 8.262
Authors: Ilse S Wicherts; Natasja M van Schoor; A Joan P Boeke; Marjolein Visser; Dorly J H Deeg; Jan Smit; Dirk L Knol; Paul Lips Journal: J Clin Endocrinol Metab Date: 2007-03-06 Impact factor: 5.958