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Nutrition, Vitamins, Supplements
Calcium Supplements Don't Work for Elderly Women to
Prevent Fractures They Won't Take Them
You can lead an elderly woman to
her medicine, but can't make her take it
April 25, 2006 - Calcium supplements appear to be
effective for preventing bone fractures in elderly women who take the
supplements regularly. Generally, however, it is an ineffective
treatment, because so many senior women do not stick with the therapy.
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Menopause reduces women's levels of the hormone
estrogen, and these lowered levels can contribute to calcium
deficiencies, according to background information in the article
published in the April 24 issue of the Archives of Internal Medicine,
one of the JAMA/Archives journals.
Calcium supplements can be used to correct this
imbalance, but it is not known if these supplements can prevent
fractures in bones weakened by the loss of calcium, a condition known as
osteoporosis.
Richard L. Prince, M.D., University of Western
Australia, Western Australian Institute of Medical Research and Sir
Charles Gairdner Hospital, Devine, and colleagues studied the effect of
calcium supplementation on 1,460 women older than age 70.
Half of the patients were randomly assigned to take
600-milligram calcium carbonate tablets twice per day and the other half
took identical placebo tablets. X-rays, bone ultrasounds and bone scans
were performed at the beginning of the study and after five years, and
adverse events that required a visit to a health care provider were
recorded at four-month intervals.
Participants returned their unused pills at the end
of each year-long period and those who took fewer than 80 percent were
classified as noncompliant.
After five years, 236 (16.2 percent) participants
sustained one or more osteoporotic fractures.
Overall, women who were assigned to the calcium
group had the same risk of fracture as those in the placebo group,
indicating that calcium supplementation did not reduce the risk of
fracture in the entire study population.
However, among the 830 women (56.8 percent of the
entire study group) - 310 in the calcium group and 320 in the placebo
group - who took 80 percent or more of their pills, were classified as
compliant. Those determined compliant in the calcium group were less
likely to develop fractures than those in the placebo group (10.2
percent vs. 15.4 percent).
Calcium treatment also improved results on several
of the bone tests. Constipation was the only adverse effect that was
more common in women taking calcium than in those taking placebo, but
there was no difference in the percentage of women who stopped taking
pills because of constipation.
Calcium supplements appeared to be ineffective at
reducing fractures because so many patients were noncompliant, the
authors write.
In patients who were compliant, there was no
difference in the amount of calcium they consumed through their regular
diet, suggesting that 1.2 grams of calcium per day is enough to help
protect women's bones.
"In conclusion, the calcium supplementation regimen
tested currently cannot be recommended as a public health approach to
fracture prevention because of the lack of long-term compliance," the
authors write.
"However, these data supported the continued use of
calcium supplements by women who are able to remain compliant with their
use. In these individuals, especially if they are under the care of a
clinician, calcium supplementation is a safe and effective therapy for
reducing the risk of osteoporitic fracture."
Editor's Note: This study was supported by a grant
from the Healthway Health Promotion Foundation of Western Australia and
by a project grant from the National Health and Medical Research Council
of Australia.
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