# Single High Dose of Vitamin D3 Annually Increases Risk of Falls and Fractures in Elderly Women

 

 

      DynaMed Weekly Update - Volume 5, Issue 21 

A number of systematic reviews and randomized trials have found evidence that vitamin D prevents falls and fractures in the elderly ([JAMA 2004 Apr 28;291(16):1999](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=15113819&), but adherence to daily supplements can be problematic for older patients. One way to address this problem might be to give vitamin D less often and use a higher dose. A recent randomized trial evaluated the efficacy of a single annual high-dose vitamin D3 supplement with 2,256 community dwelling women in Australia. Women ? 70 years old, who were at high risk for fractures, were randomized to a single annual oral dose of vitamin D3 (cholecalciferol) 500,000 units vs. placebo. They participated for 3-5 years and were followed for one year after their last dose. The vitamin D3 group experienced a higher rate of falls (83.4 vs. 72.7 per 100 person-years, p = 0.03) and an increase of radiologically-confirmed fractures (4.9 vs. 3.9 per 100 person-years, p = 0.047) ([level 1 \[likely reliable\] evidence](http://www.ebscohost.com/dynamed/levels.php)). The risk of falls remained significantly higher for the vitamin D3 group after adjustment for baseline calcium intake ([JAMA 2010 May 12;303(18):1815](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=20460620&)).

For more information, see the [Vitamin D intake and supplementation](http://search.ebscohost.com/login.aspx?direct=true&site=dynamed&id=114491) topic in DynaMed.