International Journal of Molecular Medical Science, 2025, Vol.15, No.4, 185-194 http://medscipublisher.com/index.php/ijmms 185 Meta Analysis Open Access The Effect of Vitamin D Supplementation on Fracture Risk in the Elderly: A Meta-Analysis Sufu Lü, Jianhui Li Institute of Life Science, Jiyang College of Zhejiang A&F University, Zhuji, 311800, Zhejiang, China Corresponding author: jianhui.li@jicat.org International Journal of Molecular Medical Science, 2025, Vol.15, No.4 doi: 10.5376/ijmms.2025.15.0019 Received: 17 Jun., 2025 Accepted: 24 Jul., 2025 Published: 15 Aug., 2025 Copyright © 2025 Lü and Li, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Lü S.F., and Li J.H., 2025, The effect of vitamin D supplementation on fracture risk in the elderly: a meta-analysis, International Journal of Molecular Medical Science, 15(4): 185-194 (doi: 10.5376/ijmms.2025.15.0019) Abstract This study explored whether supplementing vitamin D (alone or with calcium) in the elderly could reduce their risk of fractures. Merely supplementing vitamin D does not significantly reduce the frequency of overall fractures, hip fractures, spinal fractures or fractures in other parts. The most obvious benefits are for the elderly who are already deficient in vitamin D, consume little calcium on a regular basis, or live in institutions such as nursing homes, especially when they supplement both vitamin D and calcium at the same time. Taking large doses of vitamin D every other time may actually increase the risk of falls or fractures. Eating an appropriate amount every day or every week is safer and more effective for making up for the deficiencies in the body. Current evidence supports that supplementation should only be given to high-risk elderly people rather than to all elderly people, which can better prevent fractures and be more cost-effective. This study aims to design better trials for people deficient in vitamin D, use a uniform standard supplementation method, and develop individualized supplementation plans. Keywords Vitamin D supplementation; Elderly fractures; Meta-analysis; Calcium co-supplementation; Fracture prevention 1 Introduction Fractures, especially hip fractures, are common and serious health problems among the elderly. It is estimated that about half of women over 50 and one fifth of men over 50 will experience fractures in their later lives due to brittle bones. Hip fractures are particularly severe, with a high risk of death in the first year. They often lead to long-term mobility issues, inability to take care of themselves, and require more care and community assistance. This has brought about a significant social and economic burden, as medical expenses are high and rehabilitation and support services also take longer (Cianferotti et al., 2024). The number of elderly people worldwide is increasing, which further exacerbates the public health problems caused by osteoporotic fractures (Khatri et al., 2023). Vitamin D is very important for maintaining bone health. It can help the body absorb calcium, harden newly formed bones, and keep muscles functioning normally. A deficiency of vitamin D can lead to hyperactivity of the parathyroid glands, accelerated bone renewal, increased bone loss, and ultimately raise the risk of fractures. Adequate levels of vitamin D are also associated with stronger muscles and a lower risk of falls, both of which are crucial for preventing fractures in the elderly. Although taking vitamin D supplements can improve deficiency conditions and increase bone density, there are still different opinions on whether it can effectively reduce the risk of fractures-especially when taken alone. There is evidence suggesting that concurrent calcium supplementation may be more effective, especially for those living in institutions such as nursing homes or those who are inherently deficient in vitamin D (Chapuy et al., 1992; Lips, 2001; Boonen et al., 2006; Anagnostis et al., 2020; Cianferotti et al., 2024). This study will explore the impact of vitamin D supplementation (either alone or in combination with calcium) for the elderly on their risk of fractures. Due to the inconsistent results of some previous high-quality studies (randomized controlled trials) and summary analyses (meta-analyses), the goal of this study is to provide the latest comprehensive evidence to serve as a reference for doctors' guidance and public health measures. Understanding exactly how effective vitamin D supplementation is in preventing fractures is of great significance for improving elderly care, reducing the problems caused by fractures, and enhancing the quality of life of the elderly.
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