Preventing fractures and falls in older adults

The U.S. Preventive Services Task Force (USPSTF) has released new recommendation statements on preventing fractures and falls in older adults.

These include:

• Insufficient evidence to assess the benefit/harm of vitamin D and calcium supplementation for preventing primary fractures in men and postmenopausal women;
• Revision of an earlier, favorable assessment of vitamin D for fall prevention in 2012 to a current recommendation against vitamin D supplementation;
• Recommendation, with moderate evidence, of exercise interventions to prevent falls in adults 65 years and older;
• Recommendation, with lower level of evidence, for multi-factorial interventions, including targeting problems with balance, gait, vision, medication use, blood pressure and other factors that can contribute to increased risk of falls.

The updated recommendations, which emphasize the importance of exercise, have the potential to prevent injurious falls, the cascade of health problems that often result from such falls, and should improve general health and well-being. 

The new guidelines also call for more evidence about whether higher doses of vitamin D may help prevent falls and fractures. This is timely because two large-scale clinical trials, including VITAL, will be announcing findings on this very topic over the next year. In addition, large-scale randomized trials, including STRIDE, are evaluating the effectiveness of multi-factorial interventions in fall prevention.