USPSTF advises against vitamin D supplementation to prevent falls in older adults
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Key takeaways:
- Vitamin D supplements, with or without calcium, did not reduce fractures or falls in older adults.
- Other multifactorial interventions, like exercise, are instead recommended for fall prevention.
In a draft recommendation statement, the U.S. Preventive Services Task Force said that vitamin D supplementation with or without calcium does not prevent falls in women who have gone through menopause and men aged 60 years and older.
The task force also recommended against supplementation in these populations for the prevention of fractures.
The recommendations are D grades and contrast the USPSTF’s 2012 recommendation on vitamin D interventions for fall prevention.
“Preventing older adults from falling and breaking a bone is important to their ongoing health and independence,” USPSTF member John M. Ruiz, PhD, a professor of clinical psychology at the University of Arizona, said in a press release. “Unfortunately, when we reviewed the latest evidence, we found that taking vitamin D with or without calcium does not prevent falls or fractures in older adults, so we recommend against these supplements for people who are not taking them for other medical reasons.”
According to the CDC, more than one in four adults aged 65 years or older fall each year, while there are about 3 million fall-related ED visits and 1 million fall-related hospitalizations among older adults annually.
The expert panel noted that there are a couple new updates in the recommendation, which include the recommendation against vitamin D for fall and fracture prevention in men and the removal of mentions about specific doses.
In the evidence review, the researchers examined 20 randomized controlled trials to determine the effectiveness of vitamin D supplementation, with or without calcium, on several outcomes, such as fractures, falls, disability, quality of life, all-cause mortality and serious adverse events.
They found that the interventions did not result in reductions in mortality, falls or fractures.
The data also showed a very small increase in the incidence of kidney stones tied to vitamin D supplementation, either combined with calcium or not.
The USPSTF said that the recommendation applies to people who live at home, not those in assisted living or nursing homes. The recommendation additionally does not apply to adults who:
- are taking vitamin D or calcium for other medical reasons;
- were diagnosed with osteoporosis or vitamin D deficiency; and
- have a medical condition that affects how they absorb vitamin D.
The task force previously recommended exercise and other multifactorial interventions for fall prevention among community-dwelling adults aged 65 years and older who are at a greater risk.
“The good news is there are evidence-based ways for older adults to maintain good bone health,” Goutham Rao, MD, FAHA, a USPSTF member and the Jack H. Medalie professor at Case Western Reserve University School of Medicine, said in the release.
Comments on the draft recommendation can be submitted here from Dec. 17 through Jan. 21.
References:
- Facts About Falls. Available at: https://www.cdc.gov/falls/data-research/facts-stats/index.html. Accessed Dec. 11, 2024.
- Task Force issues draft recommendation statement on vitamin D and calcium to prevent falls and fractures in older adults. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/vitamin-d-calcium-falls-bulletin.pdf. Published Dec. 17, 2024. Accessed Dec. 17, 2024.
- Vitamin D, calcium, or combined supplementation for the primary prevention of fractures and falls in community-dwelling adults: A draft evidence update for the U.S. Preventive Services Task Force. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/vitamin-d-calcium-combined-supplementation-primary-prevention-falls-fractures-communitydwelling-adults. Accessed Dec. 17, 2024.
- Vitamin D, calcium, or combined Supplementation for the primary prevention of falls and fractures in community-dwelling Adults: U.S. Preventive Services Task Force draft recommendation statement. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/vitamin-d-calcium-combined-supplementation-primary-prevention-falls-fractures-communitydwelling-adults. Accessed Dec. 17, 2024.