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To the Editor: The study by Dr LeBoff and colleagues¹ further confirms the evidence that many older people have vitamin D deficiencies and are likely to benefit by its correction.^2-3 However, their data do not prove that such deficiency is the primary, or even a major, factor in hip fractures in the elderly.

The large age difference between the hip fracture patients and elective control patients presents problems with evaluation for which statistical analysis cannot readily adjust. The authors properly excluded patients with obvious comorbid medical conditions, but there are important comorbidities that are difficult to ascertain, especially in a presurgical setting. Many of these can be important risk factors for falls (eg, minor gait or balance difficulties, diminished vision, weaker musculature, arthritic stiffness and pain, and mild dementia) and all such conditions were surely of higher prevalence in the (mean age) 78-year-old patients in the fracture group than in . . . [Full Text of this Article]

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Occult Vitamin D Deficiency in Postmenopausal US Women With Acute Hip Fracture
Meryl S. LeBoff, Lynn Kohlmeier, Shelley Hurwitz, Jennifer Franklin, John Wright, and Julie Glowacki
JAMA. 1999;281(16):1505-1511.
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