strength or function compared with physiotherapy. Another study (Sanders et al., 2010) that examined the incidence of falls and fractures in elderly women treated with 500,000 IU of vitamin D3 annually for 3 years found a significant increase in falls and fractures in the treatment group compared with the placebo group. Notably, the increased incidence of falls was significant in the treatment group by 3 months following administration of the supplemental vitamin D. Further, as described in Chapter 6, the authors of this study concluded that levels of 65 nmol/L were not consistent with reduced rates of fall or fractures.
When this committee considered the totality of evidence for causality pertinent to the relationship between vitamin D and incidence of or risk for falls, it became clear that the greater part of the causal evidence indicated no significant reduction in fall risk related to vitamin D intake or achieved level in blood. Table 4-4 illustrates the range of clinical trial data assessing changes in fall incidence or risk for falls with varying levels of vitamin D treatment that were taken into account. Of the 18 studies considered, including several studies identified in Bischoff-Ferrari et al. (2009a), only 4 (Pfeifer et al., 2000; Harwood et al., 2004; Flicker et al.,