Endocrine Abstracts

Background: Falls in the elderly are a major public health burden as more than one in three people over 65 years falls per annum. Vitamin D deficiency is common in the elderly due to decreased sunlight exposure, dietary vitamin D intake and efficiency of cutaneous vitamin D production. Vitamin D deficiency causes myopathy, impaired psychomotor function and increased sway thus increasing the risk of falls, whilst supplementation decreases falls. We hypothesized that vitamin D deficiency was common and frequently undiagnosed in our local falls patients.

Methods: We retrospectively investigated the frequency of vitamin D measurement and supplementation in patients admitted to hospital with mechanical falls over a three month period. Patients were identified using the electronic patient record. In the same three month period the following year, we prospectively measured vitamin D using Diasorin Liaison® 25-OH Vitamin D TOTAL automated analyser in patients admitted with falls or presenting with falls to outpatients.

Results: Retrospectively, none of the 33 patients admitted with falls had vitamin D measured yet 6% were empirically prescribed vitamin D supplementation. In the prospective inpatient population, 21/60 patients were already supplemented with vitamin D. Of the non-replaced population, 59.0% were vitamin D deficient (<25 nmol/l). Whilst none of the replaced subjects had vitamin D <25 nmol/l, 42.9% had suboptimal levels (25.1–49.9 nmol/l). There was no significant difference in either median 25(OH)D or prevalence of deficiency between inpatient and outpatient populations.

Conclusion: Vitamin D deficiency is common and largely undiagnosed in both inpatients and outpatients that fall. This study emphasizes the need for better identification and prevention of vitamin D deficiency and highlights that standard oral vitamin D replacement is suboptimal.