Vitamin D and falling/fractures

January 12, 2004

(A year old article about neuromuscular and psychomotor function in

elderly and falls, but this could be applied to those of us with CMT too

~ G)

From J Bone Miner Res. 2002 May;17(5):891-7.

Neuromuscular and psychomotor function in elderly subjects who fall and

the relationship with vitamin D status.

Dhesi JK, Bearne LM, Moniz C, Hurley MV, SH, Swift CG, Allain

TJ.

Department of Health Care for the Elderly, Guy's King's and St. '

School of Medicine, London, England.

Vitamin D and calcium supplementation significantly reduces the

incidence of fractures. Evidence suggests vitamin D deficiency impairs

neuromuscular function, causing an increase in falls and thereby

fractures. The relationship between vitamin D, functional performance,

and psychomotor function in elderly people who fall was examined in a

prospective cross-sectional study. Patients were recruited from a falls

clinic and stratified according to serum 25-hydroxyvitamin-D levels

(25OHD): group 1, 25OHD < 12 microg/liter; group 2 25OHD, 12-17

microg/liter; and group 3, 25OHD > 17 microg/liter. Healthy elderly

volunteers with 25OHD > 17 microg/liter comprised group 4 (n =

20/group). Measures included aggregate functional performance time

(AFPT, seconds), isometric quadriceps strength (Newtons), postural sway

(degrees), and choice reaction time (CRT, seconds). Serum bone

biochemistry, 25OHD, and parathyroid hormone levels were

measured. Patients who fell had significantly impaired functional

performance, psychomotor function, and quadriceps strength compared with

healthy subjects (AFPT: 51.0 s vs. 32.8 s,p < 0.05; CRT: 1.66 s vs. 0.98

s,p < 0.05; strength: 223N vs. 271N, t = 2.35, p = 0.02). Group 1 had

significantly slower AFPT (66.0 s vs. 44.8 s, t = 4.15, p < 0.05) and

CRT (2.37 s vs. 0.98 s, t = 3.59, p < 0.05) than groups 2 and 3. Group 1

had the greatest degree of postural sway and the weakest quadriceps

strength, although this did not reach significance. Multivariate

analysis revealed 25OHD as an independent

variable for AFPT, CRT, and postural sway. PTH was an independent

variable for muscle strength. Older people who fall have impaired

functional performance, psychomotor function, and muscle strength.

Within this group, those with 25OHD < 12 microg/liter are the most

significantly affected.

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