Researchers recently investigated whether there is an association between calcium and vitamin D supplements and fracture incidence in community-dwelling older adults.
Studies have shown that approximately 40% of women older than 50 years old will experience a major osteoporotic fracture. These fractures come at a high cost. Additionally, the most serious type of osteoporotic fractures is hip fractures. More than one-fifth of patients died within one year after hip fracture which is shown in a cohort study that was conducted between the years 2000 and 2010. Moreover, survivors may require a greater social and nursing care.
There are practical guidelines recommending calcium and vitamin D supplements for older people to prevent fractures in people with osteoporosis. But there is no consistent data that can prove the association between calcium, vitamin D, or combined calcium and vitamin D supplements and fracture risks.
Older people who are living in nursing homes and residential care facilities have a higher risk of fracture than people who are living in the community. There might be a difference between community-dwelling men and women and people living in institutions when assessing the association of calcium and vitamin D supplements with fracture risk. In fact, clinical trials assessing calcium and vitamin D supplements and risk of fracture have recently been published.
Are Calcium and Vitamin D Supplements Associated with Hip Fractures?
Zhao and colleagues recently published a systemic review and meta-analysis study in the Journal of the American Medical Association. The researchers aimed to explore whether calcium, vitamin D, or combined calcium and vitamin D supplements are associated with a lower fracture incidence in community-dwelling older adults. They selected randomized clinical trials that compared calcium, vitamin D or combined calcium and vitamin D supplements with a placebo or no treatment for fracture incidence in community-dwelling adults who are older than 50 years. The researchers defined hip fracture as their primary outcome. Their secondary outcomes were a nonvertebral fracture, vertebral fracture and total fracture.
Calcium and Vitamin D Supplements Do Not Protect against Hip Fractures
The results indicated that there were no significant associations between either calcium or vitamin D supplements and risk of hip fracture compared with placebo or no treatment. Furthermore, there were no significant associations of combined calcium and vitamin D supplements with the risk of hip fracture compared with placebo or no treatment as well. They also found no significant associations between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of nonvertebral, vertebral, or total fractures.
Based on the results, the use of supplements, such as calcium, vitamin D or both compared with placebo or no treatment was not associated with a lower risk of fractures among community-dwelling older adults. Hence, the study findings do not support the routine use of the supplements in community-dwelling older people.
Written by Alexa Deano
Reference: Zhao, Jia-Guo, et al. “Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: a systematic review and meta-analysis.” Jama 318.24 (2017): 2466-2482.