The effect of vitamin D and calcium supplementation on falls in older adults

A systematic review and meta-analysis

Einfluss der Vitamin-D- und Kalziumsupplementierung auf Stürze bei älteren Erwachsenen

Eine systematische Übersicht und Metaanalyse



A number of studies have hypothesized that vitamin D is a potential factor in the prevention of falls in the elderly; however, the effect of vitamin D is still inconsistent and not quantitative. We conducted this meta-analysis to assess the effect of vitamin D on falls among elderly individuals.


The PubMed and Cochrane Library databases were searched from the earliest possible year up to December 2016. Two authors working independently reviewed the trials, and odds ratios (ORs) were calculated using a fixed-effect or random-effect model by Review Manager 5.3. We included only double-blind randomized, controlled trials (RCTs) of vitamin D in elderly populations that examined fall results.


A total of 26 articles were included in which 16,540 elderly individuals received vitamin D supplementation, while 16,146 were assigned to control groups. The meta-analysis showed that combined vitamin D plus calcium supplementation has a significant effect on the reduction in the risk of falls (OR for the risk of suffering at least one fall, 0.87; 95% CI, 0.80–0.94). However, no significant association between vitamin D2 or D3 and a reduction in the risk of falls was found (OR, 0.77; 95% CI, 0.58–1.03 for vitamin D2, and OR, 1.08; 95% CI, 0.98–1.20 for vitamin D3).


Combined calcium plus vitamin D supplementation is statistically significantly associated with a reduction in fall risks across various populations.



In zahlreichen Studien wurde spekuliert, dass Vitamin D ein potenzieller Faktor in der Sturzprävention bei älteren Menschen ist. Der Effekt ist jedoch weiterhin widersprüchlich und nicht quantifiziert. In der vorliegenden Metaanalyse haben wir den Einfluss von Vitamin D auf Stürze bei älteren Menschen untersucht.


Die Datenbanken PubMed und Cochrane Library wurden vom frühesten erfassten Jahr bis Dezember 2016 durchsucht. Zwei Autoren sichteten unabhängig die Studien. Unter Anwendung von Review Manager 5.3 wurden mit einem Fixed-effects- oder Random-effects-Modell Odds Ratios (OR) berechnet. Einschluss in die Analyse fanden nur doppelblinde, randomisierte, kontrollierte Studien (RCT), in denen Vitamin D in Populationen älterer Menschen eingesetzt und Sturzergebnisse ausgewertet wurden.


Insgesamt wurden 26 Beiträge eingeschlossen, in denen 16.540 ältere Menschen eine Vitamin-D-Supplementierung erhielten und 16.146 Personen Kontrollgruppen zugeteilt waren. Wie die Metaanalyse ergab, hat die kombinierte Vitamin-D- und Kalziumsupplementierung einen signifikanten Effekt auf die Reduktion des Sturzrisikos (OR für das Risiko, mindestens einen Sturz zu erleiden 0,87; 95%-Konfidenzintervall [KI] 0,80–0,94). Dagegen fand sich keine signifikante Assoziation zwischen Vitamin D2 oder D3 und einer Reduktion des Sturzrisikos (für Vitamin D2: OR 0,77; 95%-KI 0,58–1,03; für Vitamin D3: OR 1,08; 95%-KI 0,98–1,20).


Die kombinierte Vitamin-D- und Kalziumsupplementierung ist über verschiedene Populationen hinweg statistisch signifikant mit einer Reduktion des Sturzrisikos assoziiert.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6



Randomized controlled trial


Odds ratio


Confidence interval


Mean deviation


Vitamin D2


Vitamin D3


  1. 1.

    Rubenstein LZ (1997) Preventing falls in the nursing home. JAMA 278:595–596

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319:1701–1707

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Ray WA, Taylor JA, Brown AK, Gideon P, Hall K, Arbogast P, Meredith S (2005) Prevention of fall-related injuries in long-term care: a randomized controlled trial of staff education. Arch Intern Med 165:2293–2298

    Article  PubMed  Google Scholar 

  4. 4.

    Smith G, Wimalawansa SJ, Laillou A, Sophonneary P, Un S, Hong R, Poirot E, Kuong K, Chamnan C, De Los Reyes FN, Wieringa FT (2016) High prevalence of vitamin D deficiency in cambodian women: a common deficiency in a sunny country. Nutrients. doi:10.3390/nu8050290

    PubMed  PubMed Central  Google Scholar 

  5. 5.

    Chalmers J (1991) Vitamin D deficiency in elderly people. BMJ 303:314–315

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A (2007) Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370:657–666

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB (2004) Effect of Vitamin D on falls: a meta-analysis. JAMA 291:1999–2006

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Latham NK, Anderson CS, Reid IR (2003) Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review. J Am Geriatr Soc 51:1219–1226

    Article  PubMed  Google Scholar 

  9. 9.

    Consensus conference (1984): Osteoporosis.[J].JAMA: The journal of the American Medical Association 252(6):799–802

  10. 10.

    Ross AC (2011) The 2011 report on dietary reference intakes for calcium and vitamin D. Public Health Nutr 14:938–939

    Article  PubMed  Google Scholar 

  11. 11.

    Bischoff-Ferrari HA, Conzelmann M, Stahelin HB, Dick W, Carpenter MG, Adkin AL, Theiler R, Pfeifer M, Allum JH (2006) Is fall prevention by vitamin D mediated by a change in postural or dynamic balance? Osteoporos Int 17:656–663

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B (2006) Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 166:424–430

    CAS  PubMed  Google Scholar 

  13. 13.

    Grant AM, Avenell A, Campbell MK, McDonald AM, MacLennan GS, McPherson GC, Anderson FH, Cooper C, Francis RM, Donaldson C, Gillespie WJ, Robinson CM, Torgerson DJ, Group RT (2005) Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 365:1621–1628

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Burleigh E, McColl J, Potter J (2007) Does vitamin D stop inpatients falling? A randomised controlled trial. Age Ageing 36:507–513

    Article  PubMed  Google Scholar 

  15. 15.

    Flicker L, MacInnis RJ, Stein MS, Scherer SC, Mead KE, Nowson CA, Thomas J, Lowndes C, Hopper JL, Wark JD (2005) Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc 53:1881–1888

    Article  PubMed  Google Scholar 

  16. 16.

    Prince RL, Austin N, Devine A, Dick IM, Bruce D, Zhu K (2008) Effects of ergocalciferol added to calcium on the risk of falls in elderly high-risk women. Arch Intern Med 168:103–108

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H (2009) Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporos Int 20:315–322

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Karkkainen MK, Tuppurainen M, Salovaara K, Sandini L, Rikkonen T, Sirola J, Honkanen R, Arokoski J, Alhava E, Kroger H (2010) Does daily vitamin D 800 IU and calcium 1000 mg supplementation decrease the risk of falling in ambulatory women aged 65–71 years? A 3‑year randomized population-based trial (OSTPRE-FPS). Maturitas 65:359–365

    Article  PubMed  Google Scholar 

  19. 19.

    Neelemaat F, Lips P, Bosmans JE, Thijs A, Seidell JC, van Bokhorst-de van der Schueren MA (2012) Short-term oral nutritional intervention with protein and vitamin D decreases falls in malnourished older adults. J Am Geriatr Soc 60:691–699

    Article  PubMed  Google Scholar 

  20. 20.

    Berggren M, Stenvall M, Olofsson B, Gustafson Y (2008) Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up. Osteoporos Int 19:801–809

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Larsen ER, Mosekilde L, Foldspang A (2005) Vitamin D and calcium supplementation prevents severe falls in elderly community-dwelling women: a pragmatic population-based 3‑year intervention study. Aging Clin Exp Res 17:125–132

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Harwood RH, Sahota O, Gaynor K, Masud T, Hosking DJ, Nottingham Neck of Femur S (2004) A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NONOF) Study. Age Ageing 33:45–51

    Article  PubMed  Google Scholar 

  23. 23.

    Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 13:257–264

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Graafmans WC, Ooms ME, Hofstee HM, Bezemer PD, Bouter LM, Lips P (1996) Falls in the elderly: a prospective study of risk factors and risk profiles. Am J Epidemiol 143(11):1129–1136. PMID: 8633602

  25. 25.

    Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C (2000) Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 15:1113–1118

    CAS  Article  PubMed  Google Scholar 

  26. 26.

    Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, Nebiker M, Theiler R, Pfeifer M, Begerow B, Lew RA, Conzelmann M (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18:343–351

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326(7387):469. PMID: 12609940; PMCID: PMC150177

  28. 28.

    Dhesi JK, Jackson SH, Bearne LM, Moniz C, Hurley MV, Swift CG, Allain TJ (2004) Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 33(6):589–595. PMID: 15501836

  29. 29.

    Sato Y, Iwamoto J, Kanoko T, Satoh K (2005) Low-dose vitamin D prevents muscular atrophy and reduces falls and hip fractures in women after stroke: a randomized controlled trial. Cerebrovasc Dis 20(3):187–192. PMID: 16088114

  30. 30.

    Law M, Withers H, Morris J, Anderson F (2006) Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age Ageing 35(5):482–486. PMID: 16641143

  31. 31.

    Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP (2007) A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 55:234–239

    Article  PubMed  Google Scholar 

  32. 32.

    Smith H, Anderson F, Raphael H, Maslin P, Crozier S, Cooper C (2007) Effect of annual intramuscular vitamin D on fracture risk in elderly men and women – a population-based, randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford) 46:1852–1857

    CAS  Article  Google Scholar 

  33. 33.

    Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822

    CAS  Article  PubMed  Google Scholar 

  34. 34.

    Witham MD, Dove FJ, Dryburgh M, Sugden JA, Morris AD, Struthers AD (2010) The effect of different doses of vitamin D(3) on markers of vascular health in patients with type 2 diabetes: a randomised controlled trial. Diabetologia 53(10):2112–2119. doi:10.1007/s00125-010-1838-1. PMID: 20596692

  35. 35.

    Glendenning P, Zhu K, Inderjeeth C, Howat P, Lewis JR, Prince RL (2012) Effects of three-monthly oral 150,000 IU cholecalciferol supplementation on falls, mobility, and muscle strength in older postmenopausal women: a randomized controlled trial. J Bone Miner Res 27(1):170–176. doi:10.1002/jbmr.524. PMID: 21956713

  36. 36.

    Latham NK, Anderson CS, Lee A, Bennett DA, Moseley A, Cameron ID, Fitness Collaborative G (2003) A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc 51:291–299

    Article  PubMed  Google Scholar 

  37. 37.

    Hansson T, Roos B (1987) The effect of fluoride and calcium on spinal bone mineral content: a controlled, prospective (3 years) study. Calcif Tissue Int 40:315–317

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Weaver CM, Alexander DD, Boushey CJ, Dawson-Hughes B, Lappe JM, LeBoff MS, Liu S, Looker AC, Wallace TC, Wang DD (2016) Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int 27:367–376

    CAS  Article  PubMed  Google Scholar 

  39. 39.

    Murad MH, Elamin KB, Abu Elnour NO, Elamin MB, Alkatib AA, Fatourechi MM, Almandoz JP, Mullan RJ, Lane MA, Liu H, Erwin PJ, Hensrud DD, Montori VM (2011) Clinical review: the effect of vitamin D on falls: a systematic review and meta-analysis. J Clin Endocrinol Metab 96:2997–3006

    CAS  Article  PubMed  Google Scholar 

Download references


Key program of Clinical Specialty Disciplines of Ningbo (2013-88), Hua-Mei foundation (2017HMKY17)

Author information



Corresponding author

Correspondence to Prof. Qingjiang Pang.

Ethics declarations

Conflict of interest

H. Wu and Q. Pang declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wu, H., Pang, Q. The effect of vitamin D and calcium supplementation on falls in older adults . Orthopäde 46, 729–736 (2017).

Download citation


  • Vitamin D
  • Calcium
  • 25-Hydroxyvitamin D
  • 1, 25-Dihydroxyvitamin D
  • Fall risk
  • Elderly


  • Vitamin D
  • Kalzium
  • 25-Hydroxyvitamin D
  • 1,25-Dihydroxyvitamin D
  • Sturzrisiko
  • Ältere Menschen