[Fall risk and fracture. Vitamin D and falls/fractures]

Vitamin D affects both bone and muscle. Recent meta-analyses of high-quality trials showed that both native vitamin D and active forms of vitamin D3 significantly reduced the risk of vertebral and non-vertebral fractures. These anti-fracture efficacies of vitamin D are considered to be mainly exerted through direct effects on mineral metabolism. In addition, recent evidence suggests that vitamin D significantly prevents falls, to indirectly reduce fall-related fractures. The preventive effect on falls by vitamin D is considered to be exerted through effects on muscle, at least in part. Eldecalcitol, a new active vitamin D3 analogue, increases bone mineral density and shows greater evident anti-fracture efficacy than alfacalcidol. However, its effects in preventing falls remain unclear and warrant clarification.