Clinical efficacy of vitamin D in the prevention of osteoporosis and fractures in elderly patients

Osteoporosis leads to reduced bone mineral density (BMD) and increased risk of osteoporotic fractures in elderly patients, that makes it an urgent sociomedical problem. Vitamin D deficiency plays a leading role in the development of these conditions, affecting calcium-phosphorus and bone metabolisms. Despite numerous studies, the effectiveness of vitamin D in preventing osteoporosis and fractures remains a matter of scientific debates. Objective. To assess the clinical effectiveness of vitamin D in osteoporosis and fractures prevention in elderly patients according to the literature data. Materials and methods. A review of scientific works published between 2018 and 2024 has been carried out. The PubMed, Scopus, Web of Science, eLIBRARY and KiberLeninka databases have been used. Descriptions of studies and meta-analyses assessing the impact of vitamin D on BMD, risk of osteoporotic fractures and treatment safety in elderly patients are included. Publications with small sample size and low evidence level are excluded. Results. The analysis has shown that therapy with vitamin D is primarily effective for preventing osteoporosis in patients with 25-hydroxycholecalciferol (25(OH)D) deficiency (<20 ng/ml) and contributes to reducing the risk of fractures. The therapeutic effect was minimal in persons with normal vitamin D level. Issues on vitamin D high doses safety, including the risk of hypercalcemia and hypervitaminosis D, have been considered. Conclusions. The clinical effectiveness of vitamin D in osteoporosis prevention has been confirmed in elderly patients with severe 25(OH)D deficiency. An individualized approach to therapy, including regular monitoring of 25(OH)D level, is recommended to achieve optimal results. Further research is needed to develop optimal vitamin D dosing schemes and refine its combined application with other treatment methods.