To help older men and women achieve optimal vitamin D levels to maintain bone strength and prevent falls and osteoporotic fractures, the International Osteoporosis Foundation (IOF) has issued a new position statement with recommendations on vitamin D consumption and status.

As lead author Beth Dawson-Hughes and the IOF team pointed out in their paper (published online ahead of print by Osteoporosis International), the best available clinical indicator of vitamin D status—serum 25OHD—declines with age, but the response to vitamin D3 supplementation is not affected by age or usual calcium dietary intake.

The key recommendations in the IOF statement include:

  • Elderly adults need an estimated average of 800 to 1,000 IU/day of vitamin D to reach a serum 25OHD level of 75 nmol/L (30 ng/mL).
  • Persons who are obese, have osteoporosis, have limited sun exposure (e.g., those who are housebound), or have malabsorption may need to increase vitamin D intake to as much as 2,000 IU/day.
  • Clinicians should measure serum 25OHD levels in high-risk individuals, and treat if deficient.

Falls, fractures, and vitamin D were also the subject of a recent report (JAMA. 2010;303:1815-1822). In the trial, women aged 70 years and older who received a high-dose vitamin D supplement (500,000 IU, taken orally) just once a year had a higher rate of falls and fractures compared with women receiving placebo.

This was the first study to demonstrate increased risk of falls associated with any vitamin D intervention and the second to demonstrate an increased fracture risk associated with annual high-dose vitamin D therapy in older women.