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TUESDAY, April 27 (HealthDayNews) -- Vitamin D supplements can help prevent the falls that are a major cause of injury, hospitalization and death in older people, new research finds.

An analysis of five studies on the beneficial effects of vitamin D indicates that a daily vitamin D dose of 800 units reduces the incidence of falls in people aged 65 and older by 22 percent, said Dr. Heike A. Bischoff-Ferrari. She is lead author of the report in the April 28 issue of the Journal of the American Medical Association.

About one-third of all persons 65 and older fall at least once a year, leading to 1.6 million emergency room treatments and 388,000 hospitalizations, government figures show. Falls cause 11,600 deaths a year, most of them in people 75 and older who suffer hip fractures, the federal government estimates.

Previous studies have shown vitamin D reduces the number of fractures caused by falls because it strengthens bones, said Bischoff-Ferrari, an instructor in the division of rheumatology and aging at Brigham and Women's Hospital in Boston.

"The new insight that we try to show in this study is that vitamin D reduces the risk of falling by affecting muscle strength favorably," she said.

The five studies analyzed in the report compared the incidence of falls in more than 1,200 older people who took either a vitamin D supplement, calcium or a placebo, under carefully controlled conditions.

"We observed that the number of persons who took vitamin D who fell was smaller than those who took only calcium or a placebo," Bischoff-Ferrari said.

The 800-unit-a-day recommendation comes from the observation that the frequency of falls was not reduced in people who took 400 units a day of vitamin D, she said.

A vitamin supplement is advisable because "in the United States, you can get some vitamin D through milk or supplemented orange juice, but not enough," Bischoff-Ferrari said. "Ideally, it should be taken in combination with a calcium supplement."

Dr. Michael F. Holick, director of the Boston University Vitamin D Laboratory, called the 800-unit-a-day recommendation conservative.

"We think that everybody needs 1,000 units a day," Holick said. "The problem is that there are good controlled studies for 800 units a day but not for 1,000 units a day."

A standard multivitamin supplement won't provide enough vitamin D because it contains only 400 units, he said, so a specific vitamin D supplement is advisable -- at least for people who don't get out into the sun often enough.

Holick endorses exposure to sunlight as a way to boost vitamin D levels, but he said he's aware that too much time in the sun can increase the risk of skin cancer.

The advisable amount of sunlight exposure varies greatly from place to place, Holick said. Someone in New York, for example, will get maximum benefit and minimum risk by spending 12 minutes in sunlight during summer with arms and legs exposed two to three times a week between 10 a.m. and 3 p.m. For a Floridian, three to five minutes can be enough, he said.

More information

The dangers of falls for older people and sensible preventive measures are outlined by the U.S. Centers for Disease Control and Prevention. For more on vitamin D, visit the National Institutes of Health.

(SOURCES: Heike A. Bischoff-Ferrari, M.D., instructor, division of rheumatology and aging, Brigham and Women's Hospital, Boston; Michael F. Holick, M.D., Ph.D, director, Vitamin D Laboratory, Boston University; April 28, 2004, Journal of the American Medical Association)

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