Fracture Prevention With Vitamin D Supplementation

Abstract

RACTURES CONTRIBUTE SIGNIFIcantly to morbidity and mortality of older persons. Hip fractures increase exponentially with age so that by the ninth decade of life, an estimated 1 in every 3 women and 1 in every 6 men will have sustained a hip fracture. 1 With the aging of the population, the number of hip fractures is projected to increase worldwide. 2 The consequences of hip fractures are severe: 50% of older persons have permanent functional disabilities, 15% to 25% require long-term nursing home care, and 10% to 20% die within 1 year. [3][4][5][6] Besides the personal burden, hip fractures account for substantial health care expenses 3,7 with annual costs in the United States projected to increase from $7.2 billion in 1990 to $16 billion in 2020. 7 Given the high prevalence, severity, and cost of osteoporotic fractures, prevention strategies that are effective, low in cost, and well-tolerated are needed. One promising prevention strategy may be oral vitamin D supplementation. Several randomized controlled trials (RCTs) have examined vitamin D supplements for fracture prevention, but the results were conflicting. The goal of our analysis was to determine

A Scoping Review of Strategies for the Prevention of Hip Fracture in Elderly Nursing Home Residents

“…Using a Bayesian meta-analysis, we found evidence that supplementation with Vitamin D, particularly Vitamin D 3 ≥800 IU daily, reduces the risk of hip fracture in elderly nursing home residents. These results are in keeping with prior results of meta-analyses by Bischoff-Ferrari et al, particularly for doses of vitamin D 3 exceeding 400 IU per day, where data were pooled from institutionalized and community populations using a non-Bayesian analytic technique [24]; [47]. Neither sunlight exposure nor fluoride treatment was found to significantly reduce hip fractures.…”

Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe

“…We were unable to obtain data for four of the 11 identified studies that fulfilled the inclusion criteria. Our findings support and further substantiate previous meta-analyses of study level data that included these studies 1113 26 The results of our analysis were robust in effect size and direction to the exclusion of very large contributing studies.…”

Hip fracture history and risk of nonmelanoma skin cancer: a Danish population-based study

“……”