Elderly people's liability to falls and fractures is increased by many factors, including visual impairment, neurological disorders, orthopaedic disabilities, and drug effects. In one study showing that more than a third of people aged over 65 fell each year, the main risk factor was muscle weakness.1 Poor muscle strength and weakness may be associated with vitamin D deficiency, which is common among elderly people2 because the capacity of the skin to synthesise the provitamin calcidiol (25-hydroxycholecalciferol) decreases with age.
Serious deficiency of vitamin D is common among elderly housebound people in old people's homes, nursing homes, and long stay wards and has been identified as an important public health problem.2-5 In this review I discuss recent developments in screening and treating vitamin D deficiency among elderly housebound people aimed at reducing the incidence of falls and fractures.