Taking Vitamin D and Calcium Won’t Prevent Falls and Fractures in Older Adults

Taking Vitamin D and Calcium Won’t Prevent Falls and Fractures in Older Adults

Taking a vitamin D supplement, with or without calcium, does not reduce the risk of falls and fractures in older adults, according to a draft recommendation released today by the U.S. Preventive Services Task Force (USPSTF).

Vitamin D and calcium are essential for bone health and other functions. However, for men older than 60 years and post-menopausal women, the supplements don’t do anything to reduce the chances of falling and breaking bones.

This recommendation excluded people who live in nursing homes or other managed care facilities and who may have health conditions that leave them vulnerable to falls. Instead, the Task Force focused on whether vitamin D and calcium supplements prevent falls and fractures in adults who are living independently.

Roughly a quarter of people 65 and older report falling at least once in the previous year, according to the Centers for Disease Control and Prevention (CDC). Falls remain the leading cause of injury-related deaths in this group.

“Those falls cause risks of bone breaks, which can have really important health consequences. So, the task force is very interested in whether there are ways to prevent such falls and fractures in the general population of older adults,” said John Ruiz, PhD, a member of the Task Force who co-led the report and professor in the Department of Psychology at the University of Arizona.

“For these older populations that are otherwise healthy, supplementation with or without calcium at any dose was not effective,” Ruiz added.

The USPSTF usually reviews the evidence behind its recommendations every five years. It grades its recommendations based on the certainty of the evidence and how beneficial the intervention appears to be.

This latest recommendation received a D grade, meaning that there is “moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.” The draft guidelines are available on the USPSTF website, and public comments will be accepted until Jan. 21, 2025.

What Does the Evidence Say?

The Task Force considered evidence from 19 new randomized clinical trials. When researchers combined the findings from these studies, they found that the risk ratio—the number used to understand an effect size—was 0.99. This means there was essentially no difference between people taking the supplements and those who didn’t, Ruiz explained.

“There was essentially no difference at all,” Ruiz said. “It’s actually pretty rare for me to see a resource that shows such a clear result like that. Essentially nobody was helped by taking the supplement in terms of fractures.”

In 2018, the Task Force recommended against daily supplementation of 400 IU or less of vitamin D and 1,000 mg or less of calcium for the primary purpose of preventing falls in postmenopausal women. At the time, there was insufficient evidence to make a recommendation for doses below those levels in older women or any dose in men.

The recent review considered enough evidence to conclude definitively that no dose level effectively prevented falls and fractures in older adults.

Ruiz said the evidence showed there are no real harms to taking a vitamin D supplement with or without calcium other than a “very small risk” of kidney stones.

Should You Still Take a Vitamin D Supplement?

The Recommended Dietary Allowances for adults are 600 IU to 800 IU for vitamin D and 1,000 mg to 1,200 mg for calcium.

Vitamin D helps bones develop normally and remain strong. It also has other health benefits important for aging, such as reducing inflammation and supporting immune function. Calcium supplements sometimes contain vitamin D, too, because the nutrient helps the body to absorb calcium and support bone health.

“Ensuring adequate vitamin D and calcium intake is important for bone and overall health and this will not change,” Manijeh Berenji, MD, MPH, a physician certified in occupational and environmental medicine and preventive medicine and a fellow of the American College of Preventive Medicine, told Verywell in an email.

Berenji, who is not affiliated with the Task Force, said that people should talk to their healthcare provider if they are concerned about their calcium and vitamin D intake. Taking large doses of those supplements can sometimes do more harm than good, she said.

How Can You Protect Your Bones and Reduce Fall Risk?

While taking a daily vitamin D and/or calcium pill may not reduce your risk of falling and breaking a bone, there are other proven effective steps you can take.

Ruiz said the best preventive measure is adequate physical activity and exercise. Resistance training, for instance, can improve bone density and prevent muscle loss, while jumping exercises can improve balance and coordination.

“[Exercise] helps to strengthen the body against falls, as well as strengthen the body to have better balance to avoid falls in the first place,” Ruiz said.

The Task Force also recommends that older adults be evaluated for the risk of osteoporosis. Some people may be at increased risk for falls and fractures due to genetic predisposition. Routine check-ups can help those people identify the preventive measures that can keep them healthy.

What This Means For You

The Task Force only issues guidelines for preventive health, not for the treatment of health conditions. Vitamin D and calcium supplementation could be useful for managing diseases like osteoporosis and other conditions that make someone prone to fractures. People at higher risk of falling should talk to a health provider for treatment recommendations.

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