Higher doses of vitamin D did not reduce falls in at risk older adults

Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.

1. Higher doses of vitamin D did not reduce falls in at risk older adults

   Abstract: https://www.acpjournals.org/doi/10.7326/M20-3812

   Editorial: https://www.acpjournals.org/doi/10.7326/M20-7609

   URL goes live when the embargo lifts

   A randomized trial found that, compared with a lower dose, higher doses of vitamin D supplementation did not reduce falls in older persons at high risk for falls. In addition, several analyses raised safety concerns about vitamin D3 doses of 1000 IU/d or higher. The findings are published in Annals of Internal Medicine.

   Some studies have suggested that vitamin D supplements might reduce the risk for falls in older adults; however, evidence has been inconsistent, possibly because of differences in dosage.

   Researchers from Johns Hopkins University compared four doses of vitamin D3 to determine whether vitamin D supplementation reduces the risk for falls, and if so, at what dosage. The researchers randomly assigned 514 participants, aged 70 years and older, with elevated fall risk and low vitamin D blood levels to receive 200 (control), 1000, 2000, or 4000 IU/d of vitamin D3. During the dose-finding phase, the best non-control dose for preventing falls was selected. In the subsequent confirmatory phase, participants previously assigned to receive non-control doses received the best dose, and 174 new participants were randomly assigned to receive 200 IU/d or the best dose. The researchers found that vitamin D3 supplementation at doses of 1000 IU/d or higher did not prevent falls compared with 200 IU/d. No analysis found a benefit of higher dose vitamin D supplements, while some analyses suggested that the higher doses of vitamin D supplements increased the risk of serious falls and falls with hospitalization.

   Media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org.
   To reach the corresponding author, Lawrence J. Appel, MD, please contact Michel Morris at melben1@jhmi.edu.

2. Decreased sensation in the foot may be an unrecognized risk factor for death

   Abstract:
   https://www.acpjournals.org/doi/10.7326/M20-1340

   URL goes live when the embargo lifts

   A prospective cohort study found that peripheral neuropathy, or decreased sensation in the foot, may be an unrecognized independent risk factor for death. The condition was found to be common in the U.S. population, even in the absence of diabetes. The findings are published in Annals of Internal Medicine.

   Researchers from Johns Hopkins Bloomberg School of Public Health studied 7,116 adults aged 40 or older who had standardized monofilament testing for peripheral neuropathy to assess association with peripheral neuropathy and all-cause and cardiovascular mortality in the general population. They found that the prevalence of peripheral neuropathy was 27% in those with diabetes and 11.6% in those without, equal to 35 million adults based on the 2010 U.S. Census. The condition was associated with both all-cause and cardiovascular mortality in adults with and without diabetes, and these associations persisted even after adjustment for prevalent cardiovascular disease and other risk factors. According to the researchers, these findings suggest that decreased sensation in the foot may be an important risk factor for death in the general population.

   Media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org.
   To reach the corresponding author, Elizabeth Selvin, PhD, MPH, please contact Vanessa McMains at vmcmain1@jhmi.edu or Michael E. Newman at mnewma25@jhmi.edu.

Also in this issue:

Academic Health Centers' Antiracism Strategies Must Extend to Their Business Practices
Shawn F. Johnson, BS; Ayotomiwa Ojo, BS; and Haider J. Warraich, MD
Ideas and Opinions
Abstract: https://www.acpjournals.org/doi/10.7326/M20-6203

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