IOM recommendation: Elderly should get 800 IU daily for fall prevention, ideally through diet not supplements.
High dose vitamin D does not benefit, and increases fall risk.
25-OH vitamin D levels should not be routinely checked in the elderly.
One study: higher doses of vitamin D (60K/mo > 20K/mo) increased fall risk in patients > 70yo. Given monthly, not typical practice.
Individual studies of vitamin D supplementation have shown benefit in fall prevention, but meta-analyses have had mixed results. Most studies complicated by exercise/PT also included in treatment arms. It appears that the exercise/PT benefit is greater than the vitamin D benefit for community-dwelling elderly.
However, NNT = 36 for preventing hip fracture in NH elderly. (www.thennt.com)