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 .
Is fall prevention by vitamin D mediated by a change in postural or dynamic balance?
Introduction The objectives were:(1 ) to vali date a quantitative balance assessment method for fall risk prediction ; ( 2 ) to investigate whether the effect of vitamin D and calcium on the risk of falling is mediated through postural or dynamic balance , as assessed by this method . Material s and methods A secondary analysis of a double blind r and omized controlled trial was employed , which included 64 institutionalized elderly women with complete balance assessment ( age range : 65–97 ; mean 25–hydroxyvitamin D levels : 16.4 ng/ml ( SD ±9.9 ) . Participants received 1,200 mg calcium plus 800 IU cholecalciferol ( n=33 ) or 1,200 mg calcium ( n=31 ) per day over a 3-month treatment period . Using an electronic device attached to the lower back of the participant , balance was assessed as the degree of trunk angular displacement and angular velocity during a postural task ( st and ing on two legs , eyes open , for 20 s ) and a dynamic task ( get up from a st and ard height chair with arm rests , sit down and then st and up again and remain st and ing ) . Results It was found that both postural and dynamic balance independently and significantly predicted the rate of falling within the 3-month follow-up . Vitamin D plus calcium  reduced the rate of falls by 60 % [ relative risk (RR)=0.40 ; 95 % CI : 0.17 , 0.94 ] if compared with calcium alone . Once postural and dynamic balance were added to the regression analysis , they both attenuated the effect of vitamin D plus calcium on the rate of falls . For postural balance , the RR changed by 22 % from 0.40 to 0.62 if angular displacement was added to the model , and by 9 % from 0.40 to 0.49 if angular velocity was added . For dynamic balance , it changed by 1 % from 0.40 to 0.41 if angular displacement was added , and by 14 % from 0.40 to 0.54 if angular velocity was added . Discussion Thus , balance assessment using trunk angular displacement is a valid method for the prediction of falls in older women . Of the observed 60 % reduction in the rate of falls by vitamin D plus calcium supplementation compared with calcium alone , up to 22 % of the treatment effect was explained by a change in postural balance and up to 14 % by dynamic balance
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 .