title: Vitamin D and bone health outcomes in older age.
abstract: The aim of this review is to summarise the evidence linking vitamin D to bone health outcomes in older adults. A plethora of scientific evidence globally suggests that large proportions of people have vitamin D deficiency and are not meeting recommended intakes. Older adults are at particular risk of the consequences of vitamin D deficiency owing to a combination of physiological and behavioural factors. Epidemiological studies show that low vitamin D status is associated with a variety of negative skeletal consequences in older adults including osteomalacia, reduced bone mineral density, impaired Ca absorption and secondary hyperparathyroidism. There seems to be inconsistent evidence for a protective role of vitamin D supplementation alone on bone mass. However, it is generally accepted that vitamin D (17·5 μg/d) in combination with Ca (1200 mg/d) reduces bone loss among older white subjects. Evidence for a benefit of vitamin D supplementation alone on reducing fracture risk is varied. According to a recent Agency for Healthcare Research and Quality review in the USA the evidence base shows mixed results for a beneficial effect of vitamin D on decreasing overall fracture risk. Limitations such as poor compliance with treatment, incomplete assessment of vitamin D status and large drop-out rates however, have been highlighted within some studies. In conclusion, it is generally accepted that vitamin D in combination with Ca reduces the risk of non-vertebral fractures particularly those in institutional care. The lack of data on vitamin D and bone health outcomes in certain population groups such as diverse racial groups warrants attention.
authors.affiliation: School of Agriculture, Food and Rural Development and Human Nutrition Research Centre, Newcastle University, Newcastle-Upon-Tyne NE1 7RU, UK.
authors.forename: Tom R
authors.initials: TR
authors.lastname: Hill
authors.forename: Terence J
authors.initials: TJ
authors.lastname: Aspray
authors.forename: Roger M
authors.initials: RM
authors.lastname: Francis
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000187:drug effects / Q000502:physiology*; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000493:pharmacokinetics; D004032:Diet; D019587:Dietary Supplements; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D015596:Nutrition Assessment; D009752:Nutritional Status; D064887:Observational Studies as Topic; D010024:Osteoporosis / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage / Q000502:physiology*; D014808:Vitamin D Deficiency / Q000188:drug therapy
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D