Calcium and vitamin D supplementation is currently recommended to prevent fractures in older adults who have osteoporosis. However, studies evaluating the use of these supplements-alone or in combination-to reduce the incidence of fractures in older adults have produced mixed results.

Researchers conducted a meta-analysis of 33 randomized clinical trials of 51,145 men and women older than age 50 (mean age, 52 to 82 years) living in the community. They found no significant associations between the incidence of hip, vertebral, nonvertebral, or total fractures and supplementation with calcium, vitamin D, or a combination of calcium and vitamin D compared with placebo or no treatment. These findings were consistent in the subgroup analysis, regardless of dose of calcium or vitamin D, fracture history, sex, and baseline level of serum 25-hydroxyvitamin D.

The authors conclude that the routine use of calcium and vitamin D supplements among older people living in the community is not supported by their findings. However, they point out that the benefits of calcium and vitamin D supplementation may differ for those living in residential institutions, where older adults are more likely to have osteoporosis. Few of the trials reviewed in this meta-analysis, they note, included participants with osteoporosis, although some participants were noted to have risk factors for the condition.-EM

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