Should vitamin D administration for fracture prevention be continued? : A discussion of recent meta-analysis findings.
Study Goal
The researchers aimed to evaluate the effectiveness of vitamin D supplementation, with or without calcium, in preventing fractures among older adults, particularly those at risk of vitamin D deficiency.
Results Summary
Vitamin D supplementation (800-1000 IU daily or equivalent weekly/monthly doses) with or without calcium was effective in fracture prevention for adults aged 65+ at risk of deficiency, but not for those aged 50+ without deficiency or osteoporosis. Large annual bolus doses were harmful for falls and fractures.
Population
Older adults aged 65+ at risk of vitamin D deficiency and fractures; secondary analysis included adults aged 50+ without deficiency or osteoporosis.
Effective Dosage
800-1000 IU daily or equivalent weekly/monthly doses; large annual bolus doses were harmful.
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D supplementation with or without calcium | decrease | fracture prevention | older adults age 65 years and older at risk of vitamin D deficiency and fractures | - | is supported | #1 |
vitamin D supplementation | no change | primary prevention | adults age 50 years and older without vitamin D deficiency and osteoporosis | - | might not be effective | #2 |
large annual bolus administration of vitamin D | increase | falls and fractures | older adults at risk of fractures | - | is detrimental | #3 |
In consideration and critical review of four recent meta-analyses on vitamin D and fracture prevention, vitamin D supplementation with or without calcium is supported among older adults age 65 years and older at risk of vitamin D deficiency and fractures if given in daily or equivalent weekly or monthly doses of 800 to 1000 IU and with good adherence. Vitamin D supplementation might not be effective in primary prevention among adults age 50 years and older without vitamin D deficiency and osteoporosis; however, clinical trials on primary prevention are limited. Notably, large annual bolus administration of vitamin D is detrimental with regard to falls and fractures among older adults at risk of fractures and should not be continued in clinical care. Larger monthly doses of 100,000 IU need further evaluation with respect to efficacy and safety.