Cochrane Summaries

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Vitamin D and related vitamin D compounds for preventing fractures resulting from osteoporosis in older people

Avenell A, Mak JCS, O'Connell D
Published Online: 
14 April 2014

Why do older people suffer bone fractures?

Hip fractures and several other types of fractures are very common in post-menopausal women and older men due to age-related weakening of their bones (osteoporosis).

What is the impact of bone fractures in older people?

Fractures due to osteoporosis often occur in the hip, wrist or spine and can lead to considerable disability or even death. Those who survive often have reduced mobility and may require greater social and nursing care.

Why might vitamin D help?

Vitamin D is necessary for building strong bone. Older people often have low vitamin D levels because of lack of exposure to sunlight and low consumption of vitamin D in their diet. Therefore, it has been suggested that taking additional vitamin D in the form of supplements may help to reduce the risk of fractures of the hip and other bones.

Purpose of this review

To investigate the effects of vitamin D or vitamin D-related supplements, taken with or without calcium supplements, for preventing fractures in post-menopausal women and older men.

Conduct of this review

The review authors searched the medical literature up to December 2012, and identified 53 relevant medical trials, with a total of 91,791 people taking part. The trials reported fracture outcomes in postmenopausal women or men aged over 65 years from community, hospital and nursing-home settings. These trials compared vitamin D or related supplements with – or without - calcium supplements, against fake supplements (placebo), no supplement or calcium supplements alone.

Findings of this review

The review found reliable evidence that taking vitamin D only, in the forms tested in the trials, is unlikely to prevent fractures. However, reliable evidence showed that vitamin D taken with additional calcium supplements slightly reduces the likelihood of hip fractures and other types of fracture. The review found that there was no increased risk of death from taking vitamin D and calcium.

Although the risk of harmful effects (such as gastrointestinal (stomach) symptoms and kidney disease) from taking vitamin D and calcium is small, some people, particularly with kidney stones, kidney disease, high blood calcium levels, gastrointestinal disease or who are at risk of heart disease should seek medical advice before taking these supplements.

This record should be cited as: 
Avenell A, Mak JCS, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD000227. DOI: 10.1002/14651858.CD000227.pub4
Assessed as up to date: 
1 June 2013