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 .
Effects on bone mineral density of calcium and vitamin D supplementation in elderly women with vitamin D deficiency.
OBJECTIVE Calcium and vitamin D deficiency is common in older individuals , particularly those who live in nursing homes , and increases the risk of osteoporosis and fractures . METHODS We conducted a r and omized double-blind placebo-controlled study of combined supplementation with 500 mg of elemental calcium , as carbonate , and 400 IU of vitamin D bid for 12 months in women older than 65 years of age with vitamin D deficiency , defined as serum 25(OH)D concentrations < /=12 ng/ml . RESULTS Mean patient age was 75 + /- 7 years , and median daily dietary intakes of calcium and vitamin D were 697 mg and 66.8 IU in the supplemented group ( n = 95 ) and 671 mg and 61.8 IU in the placebo group ( n = 97 ) . The median serum 25(OH)D level was 7.0 ng/ml in both groups , and the medial intact parathyroid hormone ( PTHi ) levels were 49 and 48 pg/ml in the supplemented and placebo groups , respectively . The median increase in serum 25(OH)D was 22.0 ng/ml in the supplemented group and 4 ng/ml in the placebo group ( P < 0.0001 ) , and the median PTHi decrease was 17 and 5 pg/ml , respectively ( P < 0.0001 ) . The median bone mineral density increase was significantly greater in the supplemented group than in the placebo group : + 2.98 % vs. -0.21 % at L2-L4 ( P = 0.0009 ) , + 1.19 % and -0.83 % at the femoral neck ( P = 0.015 ) , + 0.86 % and -0.56 % at the trochanter ( P = 0.015 ) , and + 0.99 % and + 0.11 % for the whole body ( P = 0.01 ) . Similarly , the median decrease in the main bone markers was significantly greater in the treated group than in the placebo group : -1.35 microg/l vs. + 0.50 microg/l for bone alkaline phosphatase ( P = 0.008 ) , -16.6 nmol/mmol creatinine vs. -2.3 nmol/mmol creatinine for urinary type I amino-terminal telopeptide ( P = 0.001 ) , and -896 pmol/l vs. -201 pmol/l for serum type I carboxy-terminal telopeptide ( P = 0.003 ) . We found no significant differences between the two groups for serum calcium , although urinary calcium excretion changed more in the supplemented group than in the placebo group . In conclusion , bone mass in older women with vitamin D deficiency increases significantly at the lumbar spine , femur , trochanter , and whole body after calcium and vitamin D supplementation for 1 year , and concomitantly bone markers improved as vitamin D levels returned to normal
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 .