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Q In older people, does supplementation with vitamin D, with or without calcium, reduce fractures?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Geriatrics ★★★★★☆☆ Endocrine ★★★★★☆☆
10 databases, lists of conference abstracts, bibliographies of relevant studies, and contact with researchers in the field.
Study selection and assessment:
randomised and quasirandomised controlled trials (RCTs) that compared vitamin D or its analogue (with or without calcium) with placebo, no intervention, or calcium alone in postmenopausal women or men >65 years of age. Studies of patients on corticosteroid therapy were excluded. 2 reviewers assessed study quality.
new vertebral, hip, and other non-vertebral fractures and adverse events.
38 RCTs met the selection criteria. The quality of study methods ranged from poor to satisfactory: 34% had concealment of allocation, and 54% were blinded. Vitamin D alone did not prevent hip, vertebral, or any …
For correspondence: Dr A Avenell, University of Aberdeen, Aberdeen, UK.
Sources of funding: Australian Institute of Health and Welfare; Scottish Executive Health Department; Health Research Council of New Zealand; Medical Research Council, UK.