Can Vitamin D Supplementation Reduce the Risk of Fracture in the Elderly? A Randomized Controlled Trial

• Published in: Journal of bone and mineral research Vol. 17; no. 4; pp. 709 - 715
• Main Authors: Meyer, Haakon E., Smedshaug, Guro B., Kvaavik, Elisabeth, Falch, Jan A., Tverdal, Aage, Pedersen, Jan I.
• Format: Journal Article
• Language: English
• Published: Washington, DC John Wiley and Sons and The American Society for Bone and Mineral Research (ASBMR) 01.04.2002; American Society for Bone and Mineral Research
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cod Liver Oil - therapeutic use; Dietary Supplements; Diseases of the osteoarticular system; Female; Fractures, Bone - etiology; Fractures, Bone - prevention & control; frail elderly; hip fracture; Humans; Incidence; Male; Medical sciences; osteoporosis; Osteoporosis - complications; Osteoporosis - drug therapy; Osteoporosis. Osteomalacia. Paget disease; randomized controlled trial; Risk Factors; vitamin D; Vitamin D - therapeutic use; Human; Diseases of the osteoarticular system; Controlled therapeutic trial; Bone disease; Fracture; Supplemented diet; Brittleness; Trauma; Hip; Feeding; Micronutrient; Prevention; Osteoporosis; Randomized design; Vitamin D; Bone; Homes for the aged; Elderly
• ISSN: 0884-0431; 1523-4681
• DOI: 10.1359/jbmr.2002.17.4.709

Randomized controlled trials have shown that a combination of vitamin D and calcium can prevent fragility fractures in the elderly. Whether this effect is attributed to the combination of vitamin D and calcium or to one of these nutrients alone is not known. We studied if an intervention with 10 μg of vitamin D3 per day could prevent hip fracture and other osteoporotic fractures in a double‐blinded randomized controlled trial. Residents from 51 nursing homes were allocated randomly to receive 5 ml of ordinary cod liver oil (n = 569) or 5 ml of cod liver oil where vitamin D was removed (n = 575). During the study period of 2 years, fractures and deaths were registered, and the principal analysis was performed on the intention‐to‐treat basis. Biochemical markers were measured at baseline and after 1 year in a subsample. Forty‐seven persons in the control group and 50 persons in the vitamin D group suffered a hip fracture. The corresponding figures for all nonvertebral fractures were 76 persons (control group) and 69 persons (vitamin D group). There was no difference in the incidence of hip fracture (p = 0.66, log‐rank test), or in the incidence of all nonvertebral fractures (p = 0.60, log‐rank test) in the vitamin D group compared with the control group. Compared with the control group, persons in the vitamin D group increased their serum 25‐hydroxyvitamin D concentration with 22 nmol/liter (p = 0.001). In conclusion, we found that an intervention with 10 μg of vitamin D3 alone produced no fracture‐preventing effect in a nursing home population of frail elderly people.