Taking Vitamin D Likely Won't Shield You from Falls or Fractures—But These Strategies Might
Popping vitamin D supplements—whether combined with calcium or not—doesn’t significantly reduce the likelihood of older adults experiencing falls or fractures. This revelation stems from a draft recommendation unveiled last week by the U.S. Preventive Services Task Force (USPSTF).
Each year, more than 25% of adults over 65 in the U.S. suffer a fall. These incidents often result in fractures, bruises, or other injuries. Vitamin D, known for aiding calcium absorption essential for bone health, is frequently paired with calcium in supplements. However, according to the panel, the efficacy of this duo for preventing falls and fractures is questionable.
“Patients often come in saying they’ve heard somewhere they should be taking vitamin D and calcium for bone health,” said Barbara Bawer, MD, a family medicine physician at The Ohio State University Wexner Medical Center. “So they take them, sometimes without truly understanding why.”
It’s important to note this recommendation doesn’t apply to those with conditions like osteoporosis, a documented vitamin D deficiency, or individuals prescribed vitamin D for specific medical concerns.
While the findings suggest vitamin D doesn’t lower fall or fracture risk, it doesn’t negate the value of the vitamin or calcium entirely. Instead, the focus shifts to other, more effective ways to reduce these risks in older adults.
What Exactly Did the Panel Discover?
After sifting through extensive research on calcium, vitamin D, and their links to falls in older adults, the USPSTF panel made its position clear. With “moderate certainty,” they found that vitamin D supplementation provides no substantial benefit in preventing falls or fractures among older adults.
What’s more, the data suggest that taking vitamin D—alone or alongside calcium—may elevate the risk of kidney stones. Consequently, the panel advises against routine supplementation of vitamin D for men and women aged 60 and older to ward off fractures and falls.
This recommendation expands upon a 2018 guideline discouraging postmenopausal women from taking low-dose vitamin D (400 units or less) and calcium (1,000 mg or less) for fracture prevention. At the time, evidence for men was deemed insufficient.
Why Are Falls and Fractures More Common in Older Adults?
The reasons behind the heightened risk of falls and fractures with age are multifaceted.
“Bone density peaks in your 20s and 30s,” Alex Jahangir, MD, vice chair and professor in Vanderbilt Health’s Department of Orthopaedic Surgery, explained. “After that, bone quality begins to decline. If you fall, the chance of a fracture becomes significantly higher.”
Mobility challenges often accompany aging due to issues like osteoarthritis. “The way we walk changes—we shuffle, we lean, all to minimize pain,” noted Dr. Bawer.
Neurological conditions like neuropathy can further undermine balance, said Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica. Add deteriorating eyesight and the mix becomes even more precarious.
Additionally, older adults tend to take more medications, some of which can cause dizziness or disrupt balance, according to John Fudyma, MD, interim chief of geriatrics at the University at Buffalo.
What Role Do Vitamin D and Calcium Play?
The findings don’t dismiss vitamin D or calcium as irrelevant; they’re essential nutrients. But for the average older adult, supplementing with these isn’t the silver bullet for preventing falls and fractures.
“Vitamin D and calcium have important roles in muscle function, brain health, and of course, bone strength,” said Dr. Fudyma. “However, most older adults can—and should—obtain these nutrients through diet rather than pills.”
That said, supplementation might still be valuable for certain groups, such as:
- Individuals with osteoporosis, where bone mass and density are significantly reduced
- Those with absorption issues or nutrient-deficient diets
- People who rarely get sunlight
- Patients with conditions like hyperparathyroidism or celiac disease
“Early research shows that supplementation benefits people who are truly deficient in vitamin D or calcium,” noted Sue Shapses, PhD, RD, a nutritional sciences professor at Rutgers University.
Strategies for Reducing Falls and Fractures
Experts agree: that taking a holistic approach is the most effective way to mitigate the risks of falls and fractures as you age.
1. Embrace movement. Daily walks can bolster muscle strength, improve balance, and enhance bone health.
2. Add weight-bearing exercises. Strength training builds bone density and reduces fall-related injuries, said Dr. Segil.
3. Focus on balance. Activities like tai chi, yoga, and Pilates are excellent for stability.
4. Review medications. If osteoporosis is a concern, treatments like bisphosphonates may help reduce fracture risk.
5. Prioritize protein. A protein-rich diet supports bone strength, noted Dr. Shapses.
6. Sharpen your vision. Regular eye exams and corrective eyewear can help prevent trip hazards.
7. Get adequate rest. Fatigue heightens the risk of falls, said Dr. Bawer.
8. Declutter your environment. Clear pathways to minimize tripping hazards, urged Dr. Fudyma.
Ultimately, supplements can’t replace proactive, practical strategies for reducing fall risks. For those with adequate levels of vitamin D and calcium, supplements might add little value, Shapses explained. “But if you’re deficient? That’s a different story.”