Age and Ageing Advance Access originally published online on January 25, 2007
Age and Ageing 2007 36(2):232-233; doi:10.1093/ageing/afl176
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Vitamin D supplementation and the prevention of fractures and falls
SIR—The use of vitamin D supplementation in elderly patients to prevent fractures remains a controversial issue. Although the study by Law [1] did not show a reduction in non-vertebral fractures with vitamin D, its contribution to the argument against its efficacy in fracture prevention is questionable.There are major limitations of the study, which were not mentioned in its discussion. Importantly, it was not a double-blind, placebo-controlled study, which weakens the significance of its findings. Also, the mean duration of follow-up was only 10 months, and it is unclear as to whether this was taken into consideration in calculating the statistical power of the study. As it is known that vitamin D's effects on bone resorption are relatively modest [2], it could not have been expected to see a significantly positive result from a trial with such a short mean duration. None of the currently approved treatments for osteoporosis in double-blind, placebo-controlled studies have prospectively shown a reduction in non vertebral fractures in anything <12 months treatment and follow-up [3].
Further studies, adequately powered and with robust methodologies, are required before this controversy can be finally put to rest.
Conflict of Interest: None
Aged Care Services Department, Heidelberg Repatriation Hospital, PO Box 5444, Heidelberg West, Victoria 3081, Australia
* To whom correspondence should be addressed Tel: 61-3-9496 2192; Fax: 61-3-9496 2613. Email: henry.zeimer{at}austin.org.au
References
- Law MR, Withers H, Morris JK, Anderson F. (2006) Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age Ageing 35 482–6.
[Abstract/Free Full Text] - Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P. (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomised double-blind trial. J Clin Endocrinol Metab 80 1052–8.[Abstract]
- Pols HAP, Felsenberg D, Hanley DA, et al. (1999) Multinational, placebo-controlled, randomized trial of the effects of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: results of the FOSIT study. Osteoporosis Int 9 461–8.[CrossRef][ISI][Medline]
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