Hip fracture is one of the most common injuries the elderly face. The United States has one of the highest hip fracture rates in the world, with at least 300,000 people over the age of 65 hospitalized for it each year. As our elderly population grows, hip fractures will likely follow suit.
Recovering from a hip fracture is a lengthy process. It takes a significant physical and emotional toll on the patient and their loved ones. Furthermore, hip fractures pose a serious threat to patient’s long-term health. In fact, about 40% of those who break their hip lose their ability to walk independently, and up to 24% of patients die within one year.
Risk factors for hip fracture
There are a variety of factors that increase risk for hip fracture, including:
- Advanced age
- Low bone mineral density
- Lack of muscle strength
- Nutritional deficiencies
- Excessive vitamin A intake
- Poor mobility
- Lack of activity
- Impaired balance
Chronic vitamin D deficiency is a perfect example of a nutritional imbalance that results in bone loss over time. Contrary to popular belief, this is not primarily due to its involvement in increasing calcium absorption. Instead, researchers believe vitamin D’s role in improving balance and muscle strength explains this.
According to research, vitamin D supplementation increases the concentration of its receptors by 30% and type 1 muscle fiber size by 10% in elderly individuals.
New research on vitamin D and hip fracture recovery
The relationship between vitamin D and hip fracture is well accepted. However, the relationship between vitamin D status on hip fracture recovery has yet to be thoroughly studied. As a result, vitamin D deficiency frequently remains untreated in these patients.
In an effort to gain more insight on the matter, researchers recently conducted a study. They assessed the relationship between vitamin D status and risk of hip fracture complications. If such an association exists, the researchers planned to identify the ideal D range for better subsequent physical independence.
Researchers included a total of 1,350 patients who sustained a hip fracture, either spontaneously or from minimal trauma, in the analysis. All patients received surgery to repair the fracture and had their serum 25(OH)D levels measured a few days after their surgery. None of the patients supplemented with vitamin D at the time of fracture or over the duration of surgery and in-patient recovery.
Vitamin D levels were separated into four classes, based on their vitamin D status. The researchers measured the patient’s functional independence throughout the duration of their rehabilitation in the clinic.
What did the research show?
- Recovery improved as D levels increased, different across all four groups of vitamin D levels (p < 0.001).
- Functional outcome was significantly impaired below 12 ng/ml compared to those with higher levels (p = 0.005).
- However, there was no difference in outcome when comparing levels between 21-29 ng/ml and levels > 30 ng/ml (p = 4.21).
- After adjusting for a variety of cofactors, the relationship between functional outcome and vitamin D status remained significant (p = 0.007).
The researchers concluded,
“In our sample of inpatients with hip fracture, vitamin D status was significantly associated with the short term functional outcome.”
Final thoughts
This study shows the importance of early correction of vitamin D deficiency after hip fracture. However, due to its observational design, the study was unable to determine just how beneficial supplementation may be in improving recovery. Although it appears levels of 30 ng/ml provided the most benefit, it’s important to remember that levels between 40-60 ng/ml are optimal for improving a wide range of other health benefits, beyond bone health.
Dou you have questions regarding vitamin D, or would you like to share your experience? Connect with a member of our team today!
Source
Di Monaco, M. et al. Classes of vitamin D status and functional outcome after hip fracture: a prospective, short-term study of 1350 inpatients. European journal of physical and rehabilitation medicine, 2018.