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Background/objectives: To assess whether vitamin D supplementation prevents specific fall subtypes and sequelae (e.g., fracture). Design Secondary analyses of STURDY (Study to Understand Fall Reduction and Vitamin D in You)—a response‐adaptive, randomized clinical trial. Setting: Two community‐based research units. Participants: Six hundred and eighty‐eight participants ≥70 years old with elevated fall risk and baseline serum 25‐hydroxyvitamin D levels of 10–29 ng/ml. Intervention: 200 IU/day (control), 1000 IU/day, 2000 IU/day, or 4000 IU/day of vitamin D3. Measurements Outcomes included repeat falls and falls that were consequential, were injurious, resulted in emergency care, resulted in fracture, and occurred either indoors or outdoors. Results: After adjustment for multiple comparisons, the risk of fall‐related fracture was greater in the pooled higher doses (≥1000 IU/day) group compared with the control (hazard ratio [HR] = 2.66; 95% confidence interval [CI]:1.18–6.00). Although not statistically significant after multiple comparisons adjustment, time to first outdoor fall appeared to differ between the four dose groups (unadjusted p for overall difference = 0.013; adjusted p = 0.222), with risk of a first‐time outdoor fall 39% lower in the 1000 IU/day group (HR = 0.61; 95% CI: 0.38–0.97; unadjusted p = 0.036; adjusted p = 0.222) and 40% lower in the 2000 IU/day group (HR = 0.60; 95%CI 0.38–0.97; p = 0.037; adjusted p = 0.222), each versus control. Conclusion: Vitamin D supplementation doses ≥1000 IU/day might have differential effects on fall risk based on fall location and fracture risk, with the most robust finding that vitamin D doses between 1000 and 4000 IU/day might increase the risk of first time falls with fractures. Replication is warranted, given the possibility of type 1 error. [ABSTRACT FROM AUTHOR]

OBJECTIVES To evaluate the effect of hospitalizations on patterns of sedentary and physical activity time in mobility‐limited older adults randomized to structured physical activity or health education. DESIGN Secondary analysis of investigator‐blinded, parallel‐group, randomized trial conducted at 8 U.S. centers between February 2010 and December 2013. PARTICIPANTS Sedentary men and women aged 70 to 89 at baseline who wore a hip‐fitted accelerometer 7 consecutive days at baseline and 6, 12, and 24 months after randomization (N=1,341). MEASUREMENTS Participants were randomized to a physical activity (PA; n = 669) intervention that included aerobic, resistance, and flexibility training or to a health education (HE; n = 672) intervention that consisted of workshops on older adult health and light upper‐extremity stretching. Accelerometer patterns were characterized as bouts of sedentary (<100 counts/min; ≥1, ≥10, ≥30, ≥60 minute lengths) and activity (≥100 counts/min; ≥1, ≥2, ≥5, ≥10 minute lengths) time. Each participant was categorized as having 0, 1 to 3, or 4 or more cumulative hospital days before each accelerometer assessment. RESULTS: Hospitalization increased sedentary time similarly in both intervention groups (8 min/d for 1–3 cumulative hospital days and 16 min/d for ≥4 cumulative hospital days). Hospitalization was also associated with less physical activity time across all bouts of less than 10 minutes (≥1: −7 min/d for 1–3 cumulative hospital days, –16 min/d for ≥4 cumulative hospital days; ≥2: −5 min/d for 1–3 cumulative hospital days, −11 min/d for ≥4 cumulative hospital days; ≥5: −3 min/d for 1–3 cumulative hospital days, −4 min/d for ≥4 cumulative hospital days). There was no evidence of recovery to prehospitalization levels (time effect p >.41). PA participants had less sedentary time in bouts of less than 30 minutes than HE participants (−8 to −10 min/d) and more total activity (+3 to +6 min/d), although hospital‐related changes were similar between the intervention groups (interaction effect p >.26). CONCLUSION: Participating in a PA intervention before hospitalization had expected benefits, but participants remained susceptible to hospitalization's detrimental effects on their daily activity levels. There was no evidence of better activity recovery after hospitalization. J Am Geriatr Soc 67:261–268, 2019. [ABSTRACT FROM AUTHOR]