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What is the impact of daily oral supplementation of vitamin D3 (cholecalciferol) plus calcium on the incidence of hip fracture in older people? A systematic review and meta-analysis
Fixed-effect meta-analysis of seven RCTs (n=12,620 adults >65 y) estimated pooled odds ratio 0.75 for hip fracture with daily vitamin D3 plus calcium versus control, with stronger benefit in the subset using 800 IU D3 plus 1200 mg calcium daily (OR 0.69) than 800 IU plus 1000 mg calcium (OR 1.08).
Design
RCTs of daily vitamin D₃ + calcium vs control for hip fracture prevention in adults >65 y; fixed-effect meta-analysis.
Hip fracture (7 RCTs; n = 12,620)
- Pooled OR: 0.75 (95% CI 0.64–0.87; P = 0.0003)
- 800 IU D₃ + 1200 mg calcium/day subset (n = 5,676): OR 0.69 (0.58–0.82; P < 0.0001)
- 800 IU D₃ + 1000 mg calcium/day subset (n = 6,555): OR 1.08 (0.74–1.56; P = 0.70)
Non-vertebral fracture
Pooled OR 0.80 (95% CI 0.72–0.89; P < 0.0001) across the same seven RCTs.
Evidence hygiene
Oral supplement trial evidence—do not merge with UV / sunlight exposure RCTs; calcium dose/form and baseline status matter.
Publication
Manoj P, Derwin R, George S. Int J Older People Nurs. 2023;PubMed PMID 35842938 (see journal issue pages on PubMed).
Outcomes
- Seven RCTs (n=12,620): pooled OR hip fracture with daily vitamin D3+calcium vs control 0.75 (95% CI 0.64–0.87; P=0.0003).
- Non-vertebral fracture pooled OR 0.80 (95% CI 0.72–0.89; P<0.0001) across the same seven RCTs.