Elderly physical performance

Overview

Elderly physical performance has two reviewed supplements with mixed results. Vitamin D (WA 68; medium effect size, very high evidence, medium trust; 11 studies) did not clearly improve strength or physical performance in older adults without deficiency across most trials using varied D3 doses, though calcifediol may help walking speed in some research.

Algal Oil omega-3 (WA 32, one study) at about 1 g daily did not improve muscle strength in adults over 70, alone or combined with vitamin D and strength training. Overall evidence suggests little benefit from these supplements for physical performance in older adults. See the heatmap and evidence reviews below.

Effect graph

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Relevant supplements

Relevant supplements sorted by DEX Score.


Vitamin D	★★★★★	Medium
Algal Oil	★★★★★	Very Low / None

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Studies

Find individual evidence reviews for supplements sorted by DEX Score.

2 supplements for and rated at least stars. All purchase bands. No minimum star filter.

Vitamin DView supplement →

Consider purchase★★★★★

How we scored this

Effect SizeMediumEvidenceVery HighTrustMedium

Evidence Review

It is unclear if taking vitamin D by mouth helps improve muscle strength or physical ability in older adults who do not have low vitamin D. Studies with different doses of vitamin D3, taken daily or monthly, show no clear benefit for strength or physical performance when compared to placebo.
Some research in older women with low vitamin D showed no improvement in a common mobility test after taking vitamin D. One special form of vitamin D called calcifediol may help walking speed, but this is based on only one study, and other measures of physical ability were not improved.

Browse 11 studies3 meta-analyses

MetaEffect of Calcifediol on Physical Performance and Muscle Strength Parameters: A Systematic Review and Meta-Analysis2022n=5,446

A meta-analysis of 7 RCTs (5,446 participants) found calcifediol significantly improved handgrip strength, gait speed, and leg extension versus baseline, with less evidence for physical performance outcomes.

Effect: Benefit
Population: Older adults
Participants: 5,446
Avg age: 67.4±7.1

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RCTEffects of Vitamin D on Physical Function: Results From the STURDY Trial2022n=339

A randomized trial of 688 adults aged 70+ with low vitamin D and elevated fall risk found that vitamin D3 at 1,000–4,000 IU/day for up to 2 years did not improve physical function compared with 200 IU/day.

Effect: No Benefit
Dose: 4000 IU/day
Population: Older adults
Participants: 339
Ages: 70+

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ObservationalThe Relationship of Falls With Achieved 25-Hydroxyvitamin D Levels From Vitamin D Supplementation: The STURDY Trial2022n=395

In an observational analysis of 637 STURDY trial participants aged 70+, achieved serum 25(OH)D after 3 months of supplementation was not associated with fewer falls; consequential falls may increase when 25(OH)D reached ≥40 ng/mL.

Effect: No Benefit
Duration: 3 months
Dose: 1000 IU/day
Population: Women
Participants: 395
Ages: 70+

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MetaVitamin D Supplementation Improves Handgrip Strength in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials2022

A meta-analysis of 13 RCTs in postmenopausal women found vitamin D supplementation increased handgrip strength by 0.88 kg (95% CI 0.18–1.57) but did not improve timed up-and-go mobility.

Effect: Benefit
Population: Postmenopausal women

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RCTEffects of Vitamin D3 Supplementation and Resistance Training on 25-Hydroxyvitamin D Status and Functional Performance of Older Adults: A Randomized Placebo-Controlled Trial2021

In a 16-week RCT of 100 older adults (65–85 years), 800 IU/day or 50,000 IU/month vitamin D3 raised 25(OH)D levels but did not add benefit to resistance training for muscle strength or mobility.

Effect: No Benefit
Duration: 16 weeks
Dose: 800 IU/day
Population: Older adults
Ages: 65–85

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RCTEffect of Vitamin D Supplementation, Omega-3 Fatty Acid Supplementation, or a Strength-Training Exercise Program on Clinical Outcomes in Older Adults: The DO-HEALTH Randomized Clinical Trial2020n=275

The DO-HEALTH RCT in 2157 adults aged 70+ found 3 years of omega-3 (1 g/day), vitamin D, or exercise did not significantly improve blood pressure, cognition, fractures, or infection rates versus placebo.

Effect: No Benefit
Duration: 3 years
Dose: 1 g/day
Population: Women
Participants: 275
Avg age: ~70

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RCTA randomized controlled trial of the effects of vitamin D on muscle strength and mobility in older women with vitamin D insufficiency2010

A 1-year RCT of 302 community-dwelling women aged 70–90 with vitamin D insufficiency found 1,000 IU/day vitamin D2 improved hip muscle strength and timed up-and-go in those with the lowest baseline function.

Effect: Benefit
Dose: 1000 IU/day
Population: Women
Ages: 70–90

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RCTEffects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals2009n=242

In a 20-month RCT of 242 community-dwelling seniors, calcium plus 800 IU/day vitamin D reduced first falls by 27–39% and improved quadriceps strength and mobility versus calcium alone.

Effect: Benefit
Duration: 12 months
Dose: 800 IU/day
Population: Older adults
Participants: 242
Avg age: 77±4

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MetaFall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials2009n=2,426

A meta-analysis of 8 RCTs (2,426 participants) found high-dose vitamin D (700–1,000 IU/day) reduced fall risk by 19%, while doses below 700 IU/day did not; active vitamin D analogues reduced falls by 22%.

Effect: Benefit
Dose: 1000 IU/day
Population: Older adults
Participants: 2,426
Avg age: ~65

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RCTA higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study2007

In a 5-month RCT of 124 nursing home residents (mean age 89), 800 IU/day vitamin D reduced fall incidence by 72% versus placebo; lower doses showed no benefit.

Effect: Benefit
Duration: 5 months
Dose: 800 IU/day
Population: Older adults
Avg age: ~89

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RCTEffects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men2003

A 6-month RCT of 65 healthy community-dwelling men (mean age 76) found 1,000 IU/day cholecalciferol raised 25(OH)D and lowered PTH but did not improve muscle strength, physical performance, or health perception.

Effect: No Benefit
Duration: 6 months
Dose: 1000 IU/day
Population: Older men
Ages: 65–87

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Algal OilView supplement →

Do not purchase★★★★★

How we scored this

Effect SizeVery Low / NoneEvidenceLowTrustMedium

Evidence Review

Taking omega-3 supplements from algae, about 1 gram daily, does not seem to help improve muscle strength in people over 70.
Whether taken alone, with vitamin D, or combined with regular strength training, these supplements haven't shown clear benefits for muscle strength in older people over 70.

Browse 1 study