Supplementing Vitamin D in Unselected Elderly People through a Yearly Bolus to Reduce the Risk of Fractures: Is this Practice Effective?

A number of studies have investigated the effectiveness of vitamin D given as an annual dose to unselected elderly people to reduce the risk of fractures, but the results are conflicting. Since new clinical studies have recently been made available, we carried out an updated analysis on this issue. Our study was aimed at evaluating the effectiveness of this annual dose of vitamin D. Patients were unselected elderly people. Fractures were the endpoint of our analysis. The clinical material was represented by observational and randomized studies that included a patient group given the vitamin D annual bolus and a control group given no such supplementation. Our meta-analysis was based on the random-effect model of Der Simonian and Laird. Relative Risk (RR) was our outcome measure. After a standard PubMed search, we identified 5 clinical studies that met the criteria of our analysis (total number of patients: 115,220). The fracture rates were pooled across the studies. The meta-analytical RR was estimated to be 0.81 (95% confidence interval, 0.59 to 1.13). There was a high degree of heterogeneity in this clinical material. Our results indicate that the supplementation of vitamin D based on an annual mega-dose does not reduce the incidence of fractures in unselected elderly people.