There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures .
Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people .
Supplements of vitamin D and calcium may prevent hip or any type of fracture .
There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium .
This review found that there was no increased risk of death from taking calcium and vitamin
BACKGROUND Vitamin D and related compounds have been used to prevent  osteoporotic fractures in older people .
This is the third up date of a Cochrane review first published in 1996 .
OBJECTIVES To determine the effects of vitamin D or related compounds , with or without calcium , for preventing  fractures in post-menopausal women and older men .
Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 mg daily.
OBJECTIVES To study the effect of alfacalcidol ( 1alpha(OH)D3 ) on fall risk in community-dwelling elderly men and women . DESIGN R and omized , double-blind , placebo-controlled intervention trial . SETTING Basel , Switzerl and . PARTICIPANTS Three hundred seventy-eight community-dwelling elderly ( 191 women/187 men ) . INTERVENTION Participants were r and omly assigned to receive 1 microg of alfacalcidol or matched placebo daily for 36 weeks . MEASUREMENTS Serum 25-hydoxyvitamin D3 ( 25(OH ) D,1,25-dihydroxyvitamin D3 ( D-hormone ) , and intact parathormone ( iPTH ) levels were measured using radioimmunoassay at baseline and every 12 weeks . Numbers of fallers and falls were assessed using a question naire during each study site visit . Dietary calcium intake was assessed at baseline using a food frequency question naire . RESULTS At baseline , participants had , on average , normal vitamin D and D-hormone serum levels . Over 36 weeks , alfacalcidol treatment was associated with fewer fallers ( odds ratio (OR)=0.69 , 95 % confidence interval (CI)=0.41 - 1.16 ) than placebo . In a post hoc subgroups analysis by medians of total calcium intake , this reduction reached significance in alfacalcidol-treated subjects with a total calcium intake of more than 512 mg/d ( OR=0.45 , 95 % CI=0.21 - 0.97 , P=.042 ) but not in those who consumed less than 512 mg/d ( OR=1.00 , 95 % CI= 0.47 - 2.11 , P=.998 ) . Alfacalcidol treatment was also , independent of total calcium intake , associated with a significant 37.9 % reduction in iPTH serum levels ( P<.0001 ) . No cases of clinical ly relevant hypercalcemia were observed . CONCLUSION Provided a minimal calcium intake of more than 512 mg/d , alfacalcidol treatment significantly and safely reduces number of fallers in an elderly community dwelling population
There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures .
Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people .
Supplements of vitamin D and calcium may prevent hip or any type of fracture .
There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium .
This review found that there was no increased risk of death from taking calcium and vitamin
BACKGROUND Vitamin D and related compounds have been used to prevent  osteoporotic fractures in older people .
This is the third up date of a Cochrane review first published in 1996 .
OBJECTIVES To determine the effects of vitamin D or related compounds , with or without calcium , for preventing  fractures in post-menopausal women and older men .