Taking vitamin D, with or without calcium, does not reduce the risk of falls or fractures in older adults, according to new draft recommendations released last week by the U.S. Preventive Services Task Force.
More than one in four seniors in the United States falls each year, which can result in broken bones or other injuries. Vitamin D and calcium are sometimes taken together because the body needs vitamin D to absorb calcium, which is essential for bone health.
“In many cases, patients have read or heard from someone that they should take medication for a variety of reasons, and they are actually doing it.” Dr. Barbara Bowersaid a family medicine physician at The Ohio State University Wexner Medical Center. health.
The recommendations by the national expert panel do not apply to people with osteoporosis, vitamin D deficiency, or people taking vitamin D for other medical reasons.
The report concludes that vitamin D does not reduce the risk of fractures or falls in older adults, but does not say that vitamin D or calcium should be withheld or that they have no benefit.
Here’s what the panel found and what it actually suggests for doctors treating older patients to prevent falls and fractures.
A USPSTF panel conducted a systematic review of research on the role of calcium, vitamin D, and falls in older adults. The committee concluded with “moderate certainty” that vitamin D supplementation is not effective in preventing falls and fractures in older adults.
The panelists also found that supplementing with vitamin D, with or without calcium, may increase the risk of kidney stones. As a result, the panel does not recommend that men and women over the age of 60 supplement with vitamin D, with or without calcium, to prevent bone fractures and falls.
The committee’s findings build on a 2018 recommendation that postmenopausal women consume no more than 400 units of vitamin D and no more than 1,000 milligrams of calcium to prevent bone fractures. (At the time, the committee said there was not enough evidence to make a recommendation for men.)
There are several reasons why the risk of falls and fractures increases as we age. “Bone mass peaks in your 20s and 30s.” Alex Jahangir, MDsaid the vice president and professor of orthopedics at Vanderbilt Health. health. “As we age, the quality of our bones also declines, making us more susceptible to fractures when we fall.”
Additionally, illnesses such as osteoarthritis and other arthritis can make mobility more difficult as we age, Bower said. “This changes the way you walk, including limping and leaning in different ways to relieve the pain,” she said.
Neurological conditions, such as neuropathy, can change the sensation in your toes and feet, which can affect your balance and mobility and increase your risk of falls. Clifford Segill, D.O.said a neurologist who treats older adults at Providence St. John’s Health Center in Santa Monica, California. health.
“Visual vision typically declines with age, which can lead to falls as a result of veering off the path or not seeing something along the way,” says Bower.
Some medications can also cause dizziness and loss of balance, and older people tend to take more medications than younger people to manage their health conditions. Dr. John Hudimasaid Interim Chief of Geriatrics and Palliative Care at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. health.
According to Fudyma, vitamin D deficiency also makes you more likely to fall.
Doctors say the study results do not suggest that taking vitamin D and calcium aren’t worth it, only that the combination is unlikely to prevent fractures and falls in older people.
“Vitamin D and calcium are important for other functions in the body,” Hudima says. “However, for the general average population over the age of 60, taking supplements to prevent fractures and falls is not recommended.”
In addition to bone strength, vitamin D and calcium are needed for muscle and brain function. Doctors usually recommend getting nutrients from food rather than supplements, but supplements may be an option for people who don’t get enough nutrients from food. According to Bawer, these groups include:
- People with osteoporosis, a disease caused by decreased bone density and bone mass.
- People who have problems absorbing nutrients
- People whose diet is low in calcium
- People who spend little or only a limited amount of time outdoors
- People with hyperparathyroidism, inflammatory bowel disease, or celiac disease
“Early studies in patients with vitamin D deficiency and low calcium intake have shown the beneficial effects of supplements.” Sue Shaps, PhD, RDsaid the vitamin D researcher and professor of nutritional sciences at Rutgers University’s School of Environmental and Biological Sciences. health.
Doctors said there are several ways to reduce the risk of fractures and falls as we age.
- take a daily walk. “I tell people to walk more,” Seguil says. This not only helps strengthen muscles and bones, but also helps with balance.
- do strength training. Weight-bearing exercise can help build bone strength, Seguil says. “I recommend doing weight-bearing exercise rather than taking vitamins any day of the week,” he added.
- Let’s do some balance exercises. “Balance exercises like tai chi, Pilates, and yoga can also be helpful,” Bower says.
- Look at the medicines you are taking. People with osteoporosis can take drugs such as bisphosphonates to lower their risk of fractures, Chapseth said.
- increase protein intake. Diet-wise, consuming plenty of protein may also help reduce the risk of fractures and falls, Chapseth said.
- Always take care of your eye health. Bower suggests getting an annual eye exam and wearing necessary vision tools like glasses or contacts.
- Get enough sleep. “Make sure you’re getting enough sleep, because when people get tired, the risk of falls and fractures increases,” Bower says.
- tidy up the house. It’s also important to keep your environment tidy to reduce travel risks, Hudima says.
Unfortunately, lowering the risk of fractures and falls in older adults is not as simple as taking supplements. “For most people who have adequate levels of vitamin D and calcium, supplements will not help prevent falls or fractures,” says Shapsys. “Supplements only help if you are deficient.”
