Calcium, vitamin D, and hip fractures Incidence of falls may have decreased

Calcium, vitamin D, and hip fractures Incidence offalls may have decreased EDITOR,-Marie C Chapuy and colleagues report that treatment with cholecalciferol and calcium prevents non-vertebral fractures in elderly women and suggest that this is due to an improvement in bone metabolism.'As they mentioned in a previous report of this study, however, the result- ing increase in bone density is low.2A more likely explanation for the results might be a decrease in the incidence of falls in the active treatment group.This incidence, however, was not reported.A difference in the incidence of falls between the two groups could be explained by the muscular effects of cholecalciferol treatment.Indeed, apart from its action on bone metabolism, a low vitamin D concentration causes muscular weakness, which can be reversed by substitution.34Chapuy and colleagues mention that the mean serum concentration of 25-hydroxycholecalciferol normalised in the active treatment group but remained low in the controls.In a prospective study that I carried out in 63 elderly women (mean age 82-5 (SD 5 4) years), all living in the community and independent in basic activities of daily living, muscular strength and exercise capacity were related to serum 25hydroxycholecalciferol concentrations (table ).