Bischoff-Ferrari H A, Conzelmann M, Dick W, Theiler R, Stähelin H B
Department of Medicine, Harvard Medical School, The Robert B. Brigham Arthritis and Musculoskeletal Clinical Research Center, Boston, MA 02115, USA.
Z Rheumatol. 2003 Dec;62(6):518-21. doi: 10.1007/s00393-003-0561-4.
A successful prevention strategy for fractures in the elderly should not be limited to an improvement in bone mineral density. Equally important is the prevention of falls. Thus, 90% of fractures in the elderly are associated with a fall and 30% of all ambulatory, and 50% of institutionalized elderly age 65 years and older fall at least once a year. Fall incidence increases 10% per decade thereafter. According to recent studies, vitamin D and calcium supplementation may be a promising treatment strategy targeting both bone mineral density, as well as muscle strength and the risk of falling. The protective effect of vitamin D on fractures has been attributed to the established moderate benefit of vitamin D on bone mineral density. However, an alternative explanation might be that vitamin D affects factors directly related to muscle strength, thus, reducing fracture risk through improved function and fall prevention, in addition to its benefits on calcium homeostasis.
一项成功的老年骨折预防策略不应局限于提高骨矿物质密度。预防跌倒同样重要。因此,90%的老年骨折与跌倒有关,在所有65岁及以上的非住院老年人中,30%的人每年至少跌倒一次,在机构养老的老年人中这一比例为50%。此后,跌倒发生率每十年增加10%。根据最近的研究,补充维生素D和钙可能是一种有前景的治疗策略,既能针对骨矿物质密度,又能针对肌肉力量和跌倒风险。维生素D对骨折的保护作用归因于其对骨矿物质密度已确立的适度益处。然而,另一种解释可能是,维生素D会影响与肌肉力量直接相关的因素,因此,除了对钙稳态有益外,还可通过改善功能和预防跌倒来降低骨折风险。