Vitamin D and bone health outcomes in older age

Proc Nutr Soc. 2013 Nov;72(4):372-80. doi: 10.1017/S0029665113002036. Epub 2013 Sep 11.


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.

Publication types

  • Review

MeSH terms

  • Aged
  • Aging / physiology*
  • Bone Density / drug effects
  • Bone and Bones / drug effects
  • Bone and Bones / physiology*
  • Calcium, Dietary / administration & dosage
  • Calcium, Dietary / pharmacokinetics
  • Diet
  • Dietary Supplements*
  • Fractures, Bone / prevention & control
  • Humans
  • Nutrition Assessment
  • Nutritional Status
  • Observational Studies as Topic
  • Osteoporosis / prevention & control
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Vitamin D / administration & dosage
  • Vitamin D / physiology*
  • Vitamin D Deficiency / drug therapy


  • Calcium, Dietary
  • Vitamin D