Effects of Vitamin D Supplementation on Balance, Physical Function and Falls in Older Adults With Vitamin D Deficiency: A Systematic Review

Background. Low vitamin D status is common in later life and frequently coexists with frailty, sarcopenia, impaired mobility, and multimorbidity. Although vitamin D has biologically plausible roles in calcium regulation and skeletal-muscle function, supplementation trials have produced inconsistent findings for falls, balance, and physical performance. Objective. To critically summarize evidence on vitamin D supplementation and falls, balance, and physical performance in older adults, with attention to baseline vitamin D status and dosing regimen. Methods. Elicit was used only to support initial semantic retrieval from Semantic Scholar and Open Alex, yielding 5,000 records. The authors retained responsibility for applying prespecified eligibility criteria, reviewing the retrieved evidence, extracting and checking relevant study information, assessing its clinical and methodological relevance, and making all inclusion, interpretation, and synthesis decisions. Ninety-one records met the platform screening threshold; 80 highest-ranked records were available for processing. Because the workflow did not include a conventional multi-database search, complete full-text retrieval, duplicate independent review, or formal risk-of-bias and certainty assessment, the article is reported as structured evidence review rather than a PRISMA systematic review. No new meta-analysis was undertaken. Results. Daily or regular moderate-dose supplementation may reduce fall rates in selected deficient or institutionalized populations, whereas large intermittent bolus regimens generally showed no benefit and sometimes increased falls. Evidence for improvement in general physical performance or balance was inconsistent; possible benefit was concentrated in small studies of severe deficiency or poor baseline function. Heterogeneity and incomplete full-text availability precluded quantitative pooling and firm effect-modification conclusions. Conclusion. Vitamin D supplementation may reduce falls in selected older adults with genuine deficiency, but benefit is not consistent across populations or regimens. Evidence for balance and general physical-performance improvement is limited and heterogeneous. The evidence does not establish a precise therapeutic serum window, and high-dose intermittent regimens should not be assumed to provide greater benefit.