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April 17, 2018

Preventing Fractures and Falls: A Limited Role for Calcium and Vitamin D Supplements?

Author Affiliations
  • 1Department of Geriatrics and Aging Research, University Hospital Zurich and Waid City Hospital, University of Zurich, Zurich, Switzerland
  • 2Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
  • 3Research Program in Men’s Health: Aging and Metabolism, and the Boston Claude D. Pepper Older Americans Independence Center, Boston, Massachusetts
  • 4Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
JAMA. 2018;319(15):1552-1553. doi:10.1001/jama.2018.4023

Vitamin D and calcium are key nutrients to support bone development in children and young adults and to maintain muscle strength and neuromuscular coordination throughout the life span. Vitamin D deficiency is a well-defined risk factor for falls and hip fractures among older adults. It is unclear if supplementation with these nutrients is effective for the primary prevention of fractures among healthy community-dwelling adults.

In this issue of JAMA, the US Preventive Services Task Force (USPSTF) presents its recommendation statement on vitamin D and calcium supplementation to prevent fractures.1 These recommendations were based on a careful and comprehensive review of the evidence to determine whether supplements containing vitamin D or calcium individually or in combination contribute to the primary prevention of fractures among community-dwelling, asymptomatic adults without a diagnosis of osteoporosis or vitamin D deficiency.2 In a simultaneously published report, the USPSTF also presents its recommendation statement on interventions to prevent falls in older adults,3 based on a comprehensive review of the evidence regarding strategies for fall prevention among community-dwelling adults 65 years or older, extending from vitamin D to exercise and multifactorial interventions.4 Providing both guidelines in tandem is valuable, as the complementary articles reinforce the importance of fall prevention in reducing the risk of fractures (and other injuries) among older adults, who sustain 75% of all osteoporotic fractures.5

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