Fall prevention
Supplements studied for fall prevention.
Overview
Vitamin D (WA 56; low effect size, very high evidence, medium trust; 23 studies) may reduce fall risk by up to 26% in deficient older adults with daily dosing, but overall results are mixed and experts often do not recommend vitamin D solely for fall prevention without deficiency or osteoporosis.
Vitamin B12 and Vitamin B9 (Folate) with B12 (each WA 32) did not lower fall rates over two years in older adults also taking vitamin D, despite minor walking improvements in some over-80 participants. See the heatmap and evidence reviews below.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Vitamin D | ★★★★★ | Low |
| Vitamin B9 (Folate) | ★★★★★ | Very Low / None |
| Vitamin B12 | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
3 supplements for and rated at least stars. All purchase bands. No minimum star filter.
Vitamin DView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Vitamin D supplementation may or may not prevent falls in older adults.
- In people who are deficient, vitamin D supplementation may reduce fall risk by up to 26%.
- Generally, small daily doses are more effective than occasional large doses.
- However, some experts recommend against vitamin D solely for fall prevention unless someone has low vitamin D or osteoporosis.
Browse 23 studies·9 meta-analyses
MetaEffect of vitamin D, calcium, or combined supplementation on fall prevention: a systematic review and updated network meta-analysis2024n=58,937
A network meta-analysis of 35 RCTs (58,937 participants) found daily vitamin D 800–1,000 IU/day reduced fall risk (RR 0.85), while doses above 1,000 IU/day increased fall risk versus 800–1,000 IU.
- Effect
- Benefit
- Dose
- 1000 IU/day
- Population
- Older adults
- Participants
- 58,937
MetaEffects of active vitamin D analogues on muscle strength and falls in elderly people: an updated meta-analysis2024n=2,431
A meta-analysis of active vitamin D analogue trials (771 participants for falls, 2,431 for strength) found analogues reduced fall risk by 19% and improved quadriceps strength but not global muscle or grip strength.
- Effect
- Benefit
- Population
- Older adults
- Participants
- 2,431
MetaEffect of Vitamin D Supplementation on Risk of Fractures and Falls According to Dosage and Interval: A Meta-Analysis2022
A meta-analysis of 32 RCTs found daily vitamin D 800–1,000 IU reduced osteoporotic fracture (RR 0.87) and fall risk (RR 0.91), while 1,000 mg/day dosing and intermittent regimens did not.
- Effect
- Benefit
- Dose
- 1000 mg/day
- Population
- Adults
MetaVitamin D supplementation reduces the risk of fall in the vitamin D deficient elderly: An updated meta-analysis2021n=5,883
An updated meta-analysis of 31 RCTs (57,867 participants) found vitamin D plus calcium reduced fall risk by 12% (RR 0.88); vitamin D alone reduced falls only when baseline 25(OH)D was below 50 nmol/L.
- Effect
- Benefit
- Dose
- 1000 IU/day
- Population
- Older adults
- Participants
- 5,883
MetaVitamin D supplement on prevention of fall and fracture: A Meta-analysis of Randomized Controlled Trials2020n=58,424
A meta-analysis of 47 RCTs (58,424 participants) found vitamin D3 with calcium reduced falls (RR 0.881) and fractures (RR 0.859), while vitamin D alone showed no fracture benefit.
- Effect
- Benefit
- Population
- Women
- Participants
- 58,424
- Ages
- <80
GuideInterventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement2018
The US Preventive Services Task Force found adequate evidence that vitamin D supplementation has no benefit for preventing falls in community-dwelling adults 65+ and recommends against it (Grade D).
- Effect
- No Benefit
- Population
- Older adults
RCTEffect of isolated vitamin D supplementation on the rate of falls and postural balance in postmenopausal women fallers: a randomized, double-blind, placebo-controlled trial2016n=80
In a 9-month RCT of 160 postmenopausal women with prior falls, 1,000 IU/day vitamin D3 reduced fall incidence by 46% and improved postural balance versus placebo.
- Effect
- Benefit
- Duration
- 9 months
- Dose
- 1000 IU/day
- Population
- Postmenopausal women
- Participants
- 80
- Ages
- 50–65
RCTMonthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline: A Randomized Clinical Trial2016n=200
A 1-year RCT of 200 adults aged 70+ found monthly 60,000 IU or 24,000 IU plus calcifediol raised 25(OH)D but did not improve physical function and increased fall incidence versus 24,000 IU alone.
- Effect
- No Benefit
- Duration
- 12 months
- Dose
- 24000 IU/day
- Population
- Adults
- Participants
- 200
- Avg age
- ~78
RCTExercise and vitamin D in fall prevention among older women: a randomized clinical trial2015
In a 2-year RCT of 409 home-dwelling women aged 70–80, exercise halved injurious fall rates but 800 IU/day vitamin D did not reduce total falls or enhance exercise effects on physical function.
- Effect
- No Benefit
- Dose
- 800 IU/day
- Population
- Women
- Ages
- 70–80
Systematic reviewVitamin D supplementation and fall risk2014
This study examined vitamin D supplementation and fall risk; available evidence was insufficient to draw a concrete conclusion on benefit or harm from the published abstract.
- Effect
- Benefit
- Population
- Older adults
MetaVitamin D supplementation and falls: a trial sequential meta-analysis2014n=9,919
Trial sequential meta-analysis of 20 RCTs (29,535 participants) found vitamin D with or without calcium does not reduce falls by 15% or more, suggesting further trials are unlikely to change conclusions.
- Effect
- No Benefit
- Population
- Older adults
- Participants
- 9,919
MetaInterventions for preventing falls in older people in care facilities and hospitals2012n=60,345
A Cochrane review of 60 trials (60,345 participants) found vitamin D supplementation reduced fall rates in care facilities (RaR 0.63) but exercise effects were inconsistent; multifactorial hospital interventions reduced falls.
- Effect
- Benefit
- Population
- Older adults
- Participants
- 60,345
MetaInterventions for preventing falls in older people living in the community2012n=79,193
An updated Cochrane review of 159 trials (79,193 participants) found exercise and home safety interventions reduce community fall rates; overall vitamin D did not reduce falls (RaR 1.00) but may help when vitamin D is low.
- Effect
- No Benefit
- Population
- Women
- Participants
- 79,193
- Ages
- 65+
RCTDoes daily vitamin D 800 IU and calcium 1000 mg supplementation decrease the risk of falling in ambulatory women aged 65-71 years? A 3-year randomized population-based trial (OSTPRE-FPS)2010n=1,573
In a 3-year population RCT of 3,139 women aged 65–71, daily 800 IU vitamin D plus 1,000 mg calcium did not reduce overall fall risk, though multiple falls requiring medical attention decreased in a subsample.
- Effect
- No Benefit
- Dose
- 800 IU/day
- Population
- Women
- Participants
- 1,573
- Ages
- 65–71
MetaInterventions for preventing falls in older people in nursing care facilities and hospitals2010n=25,422
A Cochrane review of 41 trials (25,422 participants) found vitamin D reduced fall rates in nursing care facilities (RaR 0.72) and multifactorial interventions reduced hospital falls.
- Effect
- Benefit
- Population
- Older adults
- Participants
- 25,422
Systematic reviewPrimary care-relevant interventions to prevent falling in older adults: a systematic evidence review for the U.S. Preventive Services Task Force2010
A systematic review of 61 primary care trials found exercise (RR 0.87) and vitamin D supplementation (RR 0.83) each reduced falling in community-dwelling older adults.
- Effect
- Benefit
- Population
- Older adults
MetaVitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis2010
A meta-analysis of 10 RCTs found vitamin D therapy (200–1,000 IU/day) reduced falls by 14% (RR 0.86) in older adults, with greater benefit at doses ≥800 IU and durations longer than 6 months.
- Effect
- Benefit
- Dose
- 1000 IU/day
- Population
- Older adults
- Ages
- ≥60
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
MetaDifferential effects of D-hormone analogs and native vitamin D on the risk of falls: a comparative meta-analysis2008n=21,268
A meta-analysis of 14 trials (21,268 participants) found vitamin D hormone analogues (alfacalcidol, calcitriol) prevented falls more effectively than native vitamin D (RR 0.79 vs 0.94).
- Effect
- No Benefit
- Population
- Older adults
- Participants
- 21,268
RCTEffects of ergocalciferol added to calcium on the risk of falls in elderly high-risk women2008n=302
A 1-year RCT of 302 women aged 70–90 in Perth found ergocalciferol 1,000 IU/day plus calcium reduced fall risk by 19%, mainly in winter and among single-fall events.
- Effect
- Benefit
- Duration
- 1 year
- Dose
- 1000 IU/day
- Population
- Women
- Participants
- 302
- Ages
- 70–90
RCTOral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial2005n=5,292
In 5,292 elderly fracture patients, 800 IU vitamin D3 with or without 1000 mg calcium did not reduce new low-trauma fractures over up to 62 months.
- Effect
- No Benefit
- Duration
- 24–62 months
- Dose
- 800 IU/day
- Population
- Women
- Participants
- 5,292
- Avg age
- ~70
ObservationalHigher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y2004n=4,100
In a US population survey of 4,100 adults aged 60+, higher serum 25(OH)D (40–94 nmol/L) was associated with better lower-extremity function on walk and sit-to-stand tests.
- Effect
- Benefit
- Population
- Adults
- Participants
- 4,100
- Ages
- 60+
RCTEffects of vitamin D and calcium supplementation on falls: a randomized controlled trial2003n=62
In a 12-week RCT of 122 elderly women (mean age 85) in long-stay care, 800 IU vitamin D plus 1,200 mg calcium reduced falls by 49% versus calcium alone and improved musculoskeletal function.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 1200 mg/day
- Population
- Women
- Participants
- 62
- Ages
- 63–99
Vitamin B12View supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking vitamin B12 and folic acid supplements every day for two years does not lower the chance of falling in older adults.
- These vitamins do not seem to help prevent falls, even when taken with vitamin D.
Browse 1 study
RCTA Randomized Controlled Trial to Examine the Effect of 2-Year Vitamin B12 and Folic Acid Supplementation on Physical Performance, Strength, and Falling: Additional Findings from the B-PROOF Study2016n=2,919
A randomized trial of 2919 older adults found that 600 IU/day for 2 years moreover, time to first fall was not significantly different (HR: 1.0, 95% CI 0.9-1.2).
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 600 IU/day
- Population
- Older adults
- Participants
- 2,919
- Ages
- 65+
Vitamin B9 (Folate)View supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking folic acid and vitamin B12 daily for two years does not reduce the risk of falls in older adults who are also taking vitamin D. Both groups experienced similar declines in physical strength and balance.
- Some small improvements were seen in walking ability for people over 80 who took the supplements regularly.
- Overall, these vitamins do not help prevent falls in most older adults.
Browse 1 study
RCTA Randomized Controlled Trial to Examine the Effect of 2-Year Vitamin B12 and Folic Acid Supplementation on Physical Performance, Strength, and Falling: Additional Findings from the B-PROOF Study2016n=2,919
A randomized trial of 2919 older adults found that 600 IU/day for 2 years moreover, time to first fall was not significantly different (HR: 1.0, 95% CI 0.9-1.2).
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 600 IU/day
- Population
- Older adults
- Participants
- 2,919
- Ages
- 65+
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Vitamin D | ★★★★★56% | 23 | 9 | 92% |
| Vitamin B12 | ★★★★★32% | 1 | 0 | 4% |
| Vitamin B9 (Folate) | ★★★★★32% | 1 | 0 | 4% |