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 .
Clinical and laboratory safety of one year's use of a combination calcium + vitamin D tablet in ambulatory elderly women with vitamin D insufficiency: results of a multicenter, randomized, double-blind, placebo-controlled study.
OBJECTIVE This article presents the results of an evaluation of the clinical and laboratory safety of a 1-year course of treatment with a combination calcium and vitamin D tablet in ambulatory women aged > 65 years with vitamin D insufficiency . METHODS In a multicenter , r and omized , double-blind , placebo-controlled  study conducted in France , women with a 25-hydroxyvitamin D level < or = 12 ng/mL were r and omized to receive either a combination tablet containing calcium carbonate 500 mg and vitamin D3 400 IU taken twice daily or a matching placebo tablet for 1 year . A complete clinical examination was performed at baseline and at 3 , 6 , 9 , and 12 months of treatment ; blood and urine sample s were collected for laboratory analyses at the same time points . Safety was monitored based on adverse events recorded during the treatment period and on the results of laboratory tests , including measurement of creatinine and uric acid levels . RESULTS The study included 192 women ( mean [ SD ] age , 74.6 [ 6.9 ] years ; mean weight , 64.0 [ 12.5 ] kg ) , 95 in the calcium + vitamin D group and 97 in the placebo group . Fifty women ( 21/95 [ 22.1 % ] calcium + vitamin D , 29/96 [ 30.2 % ] placebo ) were prematurely withdrawn from the study for various reasons , with no difference in withdrawals between groups . Treatment-related adverse events were reported in 21 ( 22.1 % ) and 23 ( 24.0 % ) women in the respective treatment groups . These events consisted mainly of metabolic disorders ( 9 [ 9.5 % ] and 10 [ 10.4 % ] , respectively ) , particularly hypercalcemia ( 6 [ 6.3 % ] and 8 [ 8.3 % ] ) and gastrointestinal disorders ( 9 [ 9.5 % ] and 8 [ 8.3 % ] ) . No major complications directly related to calcium and vitamin D supplementation occurred during the course of treatment . Although renal function was not altered , the group who received calcium + vitamin D had significantly elevated concentrations of serum uric acid compared with those who received placebo ( 52.3 % vs 37.2 % ; P = 0.046 ) but not urinary uric acid . CONCLUSIONS In these ambulatory elderly women with vitamin D deficiency , supplementation with calcium + vitamin D appeared to be well tolerated over 1 year of treatment . No significant effects on creatinine clearance were observed . However , the proportion of women with elevated serum uric acid concentrations was significantly greater in those who received calcium + vitamin D compared with those who received placebo
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 .