- Overview Fractures and vitamin D
- Fewer falls and fractures as vitamin D is increased – 1800 to 4000 IU July 2010
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- 1 in 3 died after hip fracture but only 1 in 14 if add Vitamin D and exercise – RCT April 2017
- Hip fractures reduced 2X to 6X with just 10 minutes of sunlight daily – RCT 2003-2010
- Few Fractures if high Magnesium intake – 2X fewer for men, 2.6X for women – June 2017
Epidemiology of fragility fractures and fall prevention in the elderly: a systematic review of the literature - Nov 2017
Curr Orthop Pract. 2017 Nov;28(6):580-585. doi: 10.1097/BCO.0000000000000563. Epub 2017 Oct 27.
Fragility fractures in the elderly is an ongoing concern for orthopaedic surgeons. A 50-year-old woman has a 40% chance of having a vertebral compression fracture in her lifetime.
The incidence of vertebral fractures, reported to be more than 10 times higher than that of femoral fractures, is estimated as 1-1.5 million per year in Japan.
Vertebral fractures often occur without a fall, whereas the majority of nonvertebral fractures are the consequence of falls; the site of the nonvertebral fracture appears to be dictated by the type of fall. Distal radial fractures commonly occur as a consequence of hand protection during the fall. In older patients, falling load tends to directly affect shoulder and hip joints and lead to proximal humeral and femoral fractures. The incidence of vertebral fractures is increased in women over 50 yr of age, following the same trend as osteoporosis prevalence.
Conversely, the mean age for proximal femoral fractures is around 80 yr, and more than 75% of femoral fractures occur in individuals over the age of 75.
The prognostic risk of aging is 11-fold greater than that of reduced bone mineral density, and age is another risk factor for femoral fractures. Prophylactic therapy for osteoporosis and femoral fractures was shown to more effective in women in their 70s than in those over the age of 80.
Although several approaches, including
- exercise therapy,
- vitamin D administration, and
- environmental adjustment at home,
have been reported to be effective in fall prevention, effective fracture prevention approaches in frail elderly individuals have not yet been well established.
PMID: 29177024 PMCID: PMC5671779 DOI: 10.1097/BCO.0000000000000563
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- “A 50-year-old woman has a 40% chance of having a vertebral compression fracture in her lifetime. Epidemiological studies found radiographically diagnosed vertebral compression fractures in 8% to 13% of women in their 60s that increased to 30% to 40% in women in their 70s.”
Bone Joint J. 2015 Jan;97-B(1):89-93. doi: 10.1302/0301-620X.97B1.34558.
Maier GS1, Seeger JB1, Horas K2, Roth KE3, Kurth AA4, Maus U5.
Strength and probability of associations with Vitamin D deficiency
Hypovitaminosis D has been identified as a common risk factor for fragility fractures and poor fracture healing. Epidemiological data on vitamin D deficiency have been gathered in various populations, but the association between vertebral fragility fractures and hypovitaminosis D, especially in males, remains unclear. The purpose of this study was to evaluate serum levels of 25-hydroxyvitamin D (25-OH D) in patients presenting with vertebral fragility fractures and to determine whether patients with a vertebral fracture were at greater risk of hypovitaminosis D than a control population. Furthermore, we studied the seasonal variations in the serum vitamin D levels of tested patients in order to clarify the relationship between other known risk factors for osteoporosis and vitamin D levels. We measured the serum 25-OH D levels of 246 patients admitted with vertebral fractures (105 men, 141 female, mean age 69 years, sd 8.5), and in 392 orthopaedic patients with back pain and no fractures (219 men, 173 female, mean age 63 years, sd 11) to evaluate the prevalence of vitamin D insufficiency. Statistical analysis found a significant difference in vitamin D levels between patients with vertebral fragility fracture and the control group (p = 0.036). In addition, there was a significant main effect of the tested variables: obesity (p < 0.001), nicotine abuse (p = 0.002) and diabetes mellitus (p < 0.001). No statistical difference was found between vitamin D levels and gender (p = 0.34). Vitamin D insufficiency was shown to be a risk factor for vertebral fragility fractures in both men and women.
PMID: 25568419 DOI: 10.1302/0301-620X.97B1.34558
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*"In this study we identified an 89% prevalence of hypovitaminosis D in patients with vertebral fractures"