Preventing Falls and Fractures: What Older Adults Need to Know About Vitamin D and Calcium
As people age, maintaining bone health becomes essential to preserving mobility, independence, and overall quality of life. Two key nutrients—vitamin D and calcium—play a central role in preventing falls and fractures among older adults. However, experts emphasize that balance is just as important as quantity when it comes to supplementation.
According to Dr. Bess Dawson-Hughes, a senior scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, reaching one’s 50s is an important time to reassess daily intake of these nutrients. Calcium helps slow bone loss, while vitamin D supports calcium absorption and contributes to muscle strength and balance.
In women, bone loss accelerates during the menopause transition, with an average decline of about 3% per year, and can exceed 5% in the years following the final menstrual period as estrogen levels drop. After this phase, bone loss continues at approximately 1% per year. In men, bone loss typically begins around age 50 and progresses steadily at a similar rate.
This gradual loss of bone density weakens the skeleton and significantly increases the risk of fractures, particularly after a fall. At the same time, insufficient vitamin D can impair muscle strength and balance, further raising the risk of falling. As a result, hip fractures—one of the most serious injuries in older adults—rise sharply among individuals in their 70s and 80s.
However, experts caution that more is not always better. Excessive calcium intake can increase the risk of kidney stones, while high doses of vitamin D have not consistently shown added benefits. Clinical trials indicate that vitamin D supplementation helps individuals who are deficient, but benefits tend to plateau at higher doses. In some older adults with elevated blood levels of vitamin D, studies have even linked excess levels to an increased risk of falls and fractures.
Current guidelines recommend that women aged 51 and older and men aged 71 and older consume 1,200 milligrams of calcium per day, while men between 51 and 70 require 1,000 milligrams daily. For vitamin D, the recommended intake is 15 micrograms (mcg) for adults aged 51 to 70 and 20 mcg for those over 70.
Dairy products—such as milk, yogurt, and cheese—remain the primary source of calcium in most American diets. Adults who do not consume at least two servings of dairy daily may benefit from a 500-milligram calcium supplement. For vitamin D, sunlight exposure can be sufficient in sunnier climates, but in northern regions or during winter months, older adults may need to supplement with 800 to 1,000 IU daily.
Finally, experts note that appetite often decreases with age, making careful nutritional choices even more important. Ensuring adequate—but not excessive—intake of vitamin D and calcium can make a meaningful difference in reducing the risk of falls, fractures, and age-related complications.
