• Mayo Clinic Minute: Exercise helps prevent bone fractures and falls

Vitamin D supplements no longer are recommended to prevent falls for people 65 years or older, according to new guidelines by the U.S. Preventative Services Task Force (USPSTF). Instead, the emphasis is on exercise. The new recommendations do not apply to people with increased risk for falls or a diagnosis of osteoporosis.

Dr. Robert Wermers, an endocrinologist at Mayo Clinic, says many individuals with osteoporosis have a high risk of falling, especially with older age:

Falls are often the cause of fractures, especially of the wrist and hip. Exercise is one of the few interventions that has been shown to reduce the number of people who fall and get injured with falls. Although vitamin D and calcium can benefit bone health, especially in those who do not get an adequate amount of calcium in their diet or have low levels of vitamin D, neither has been clearly shown to reduce falls. In fact, very high doses of vitamin D appear to increase the risk of falls.

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About 1 in 4 women and 1 in 17 men over 65 will develop osteoporosis, according to the Centers for Disease Control and Prevention.

"Osteoporosis essentially is where you have a lack of structure or mineral in the bone, so you’re more predisposed to fracturing or breaking bones,” says Dr. Wermers.

As people age, the risks of falls and bone fractures rise. Dr. Wermers says the most common fractures from falls are spine fractures. And hip fractures are the most serious.

Osteoporosis often shows no symptoms, so Dr. Wermers encourages those at risk to get screened. "A lot of people will have osteoporosis and not even know they have it, unless they get a bone density test,” Dr. Wermers says.

There are ways to improve your health and reduce your risks. Dr. Wermers recommends any nonimpact balance exercise, such as tai chi two or three times a week, to help reduce falls for older adults.

He says a combination approach is best. "The best way to take good care of your bones would be to make sure you get enough calcium in your diet, exercise, [get] a combination of aerobic walking type of exercise where you’re bearing your weight, where you’re putting weight on your heels.”