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Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence

Record type: Article

Osteoporotic fractures are an extremely common and serious health problem in the elderly. This article presents the rationale for calcium and vitamin D supplementation in the prevention and treatment of osteoporotic fractures and reviews the literature evidence on the efficacy of this strategy. Two musculoskeletal risk factors are implicated in osteoporotic fractures in the elderly: the loss of bone mass due to secondary hyperparathyroidism and the increased propensity to falls. Calcium and vitamin D reverse secondary hyperparathyroidism with resultant beneficial effects on bone mineral density (BMD). Additionally, calcium and vitamin D supplementation significantly improves body sway and lower extremity strength, reducing the risk of falls. The effects of combined calcium and vitamin D on parathyroid function and BMD provide a strong rationale for the use of this therapy in the prevention and treatment of osteoporosis and osteoporotic fractures. There is general agreement that, in patients with documented osteoporosis, calcium and vitamin D supplementation should be an integral component of the management strategy, along with antiresorptive or anabolic treatment. Frail elderly individuals constitute another major target population for calcium and vitamin D because evidence from randomized studies in institutionalized elderly subjects demonstrates that these supplements reduce osteoporotic fracture risk, particularly in the presence of dietary deficiencies. However, the results of trials in community-dwelling subjects have been equivocal. Within the primary-care setting, further research is required to establish appropriate target subgroups for calcium and vitamin D supplementation; overall, the data are consistent with a benefit individuals with insufficient calcium and/or vitamin D, although patients with documented osteoporosis will derive further benefit in terms of fracture prevention from the addition of an antiresorptive agent.

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Citation

Boonen, S., Bischoff-Ferrari, H.A., Cooper, C., Lips, P., Ljunggren, O., Meunier, P.J. and Reginster, J.Y. (2006) Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence Calcified Tissue International, 78, (5), pp. 257-270. (doi:10.1007/s00223-005-0009-8).

More information

Published date: 2006
Keywords: research, calcium, bone, risk factors, risk, therapy, vitamin d, function, osteoporosis, review, elderly, deficiency, mass, extremities, health, bone mass, fractures

Identifiers

Local EPrints ID: 60925
URI: http://eprints.soton.ac.uk/id/eprint/60925
ISSN: 0171-967X
PURE UUID: 6df39e17-300a-421f-918e-a5c7b4052f85

Catalogue record

Date deposited: 10 Sep 2008
Last modified: 17 Jul 2017 14:23

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Contributors

Author: S. Boonen
Author: H.A. Bischoff-Ferrari
Author: C. Cooper
Author: P. Lips
Author: O. Ljunggren
Author: P.J. Meunier
Author: J.Y. Reginster

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