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Abstract
Bioavailable 25-hydroxyvitamin D (bio25(OH)D), the fraction not bound to vitamin D binding protein, may influence neuromuscular outcomes and fall risk, but evidence is limited. This study examined associations of bio25(OH)D and total 25(OH)D with falls among 674 elderly men in the MrOS cohort. Bio25(OH)D was estimated using validated models, and falls were self-reported over 12 months. Regression analysis showed lower fall risk in the third quartile of bio25(OH)D versus the highest (RR=0.65; 95% CI: 0.45–0.96), while total 25(OH)D showed no significant association. Spline analyses suggested nonlinear relationships. Findings indicate bio25(OH)D may be more strongly linked to fall risk than total 25(OH)D, warranting further investigation.