High-dose vitamin D recommended for elderly

The results of a recent literature review suggest that only a high intake of vitamin D leads to a significant reduction in the risk of fracture. The report, published July 5 in the New England Journal of Medicine, supports the recommendation of the Institute of Medicine that people aged 65 years and older should receive 800 IU of vitamin D per day.

Lead author, Heike A. Bischoff-Ferrari, MD, DrPH, of the University Hospital Zurich in Switzerland, and colleagues, wrote that the incidence of hip fractures in the elderly is expected to increase by 240% by the year 2050. Universal vitamin D supplementation has been one strategy discussed for curbing this trend; however, data on the benefit of vitamin D supplementation has been unclear.

The researchers examined the findings from 11 studies, including 30,011 participants aged 65 years and older, to estimate the effects of vitamin D supplementation according to the actual intake of each participant, rather than the dose to which the participant was randomly assigned.

They found that participants in the highest intake quartile (median 800 IU daily; range 792 to 2,000 IU) had a significant reduction (30%) in the risk of hip fracture and a 14% reduction in nonvertebral fracture risk, compared with controls.

“Our data suggest that high-dose vitamin D supplementation (≥800 IU per day) may reduce the risk of hip fracture in persons 65 years of age or older, independently of type of dwelling, age, and sex,” the authors wrote. “Furthermore, our data support a 25-hydroxyvitamin D level above 60 nmol per liter for the prevention of fractures.”