Reducing hip fractures in the elderly

Figures & data

Table

Systematic reviews:	3
Meta-analysis:	1
RCTs:	2

Table

Systematic reviews:	4
Meta-analysis:	3

Table 1 The two most recent RCTs with conflicting results^10,11

Author	Population	No. enrolled	Compliance	Conclusion
Koike, et a1^Citation11	High-risk residential elders	672	79.7%	Hip protectors effective at reducing hip fractures in high-risk patients
Kiel, et a1^Citation10	Nursing home residents	531	73.8%	Ineffective at preventing hip fractures

Table 2 Summary of systematic reviews and recent meta-analyses of vitamin D alone versus vitamin and calcium supplementation for prevention of hip fractures

Author	Type	Vitamin D alone	Vitamin D and Calcium	Conclusion
Avenell, et al^Citation12	Review of 45 RTCs	Not beneficial	Beneficial	Recommend combined vitamin D and calcium supplementation in frail older people in institutions. Unclear effect on community dwellers
Izaks, et al^Citation14	Review of 11 RCTs	Not beneficial (low dose)	Beneficial	Vitamin D (high dose) and calcium showed decreased fracture risk in institutionalized patients. Low dose vitamin D is ineffective, and there is not sufficient data on high dose vitamin D alone
MacLean, et al^Citation13	Review of 7 RCTs	Beneficial	Beneficial	Vitamin D with or without calcium supplementation reduces risk of nonvertebral fractures. One study of calcium supplementation alone showed no effect
Sawka, et al^Citation9	Review of 7 RCTs	Beneficial	Beneficial	High dose vitamin D supplementation with or without calcium reduces risk of hip fracture
Tang, et al^Citation15	Meta-analysis of 29 RCTs	Not investigated	Beneficial	Calcium alone or in combination with vitamin D is effective at preventing fractures. Both are more effective in high doses
Bischoff-Ferrari, et al^Citation16	Review of 7 RCTs	Unable to determine	Beneficial	High dose vitamin D supplementation with calcium reduces risk of hip and nonvertebral fracture in community and institutionalized settings
Jackson, et al^Citation17	Meta-analysis of 9 RCTs	Not beneficial	Not beneficial	Though no statistically significant fracture reduction demonstrated, there was a trend toward reduced risk
Bergmana, et al^Citation18	Meta-analysis of 8 RCTs	Not investigated	Beneficial	Vitamin D3 and calcium supplementation reduced hip fractures as compared to placebo

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