Premium
Alfacalcidol Reduces the Number of Fallers in a Community‐Dwelling Elderly Population with a Minimum Calcium Intake of More Than 500 Mg Daily
Author(s) -
Dukas Laurent,
Bischoff Heike A.,
Lindpaintner Lyn S.,
Schacht Erich,
Birknerbinder Dagmar,
Damm Thomas N.,
Thalmann Beat,
Stähelin Hannes B.
Publication year - 2004
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2004.52060.x
Subject(s) - alfacalcidol , medicine , vitamin d and neurology , placebo , confidence interval , odds ratio , post hoc analysis , randomized controlled trial , parathyroid hormone , population , vitamin d deficiency , endocrinology , calcium , physical therapy , osteoporosis , bone mineral , alternative medicine , environmental health , pathology
Objectives: To study the effect of alfacalcidol (1α(OH)D 3 ) on fall risk in community‐dwelling elderly men and women. Design: Randomized, double‐blind, placebo‐controlled intervention trial. Setting: Basel, Switzerland. Participants: Three hundred seventy‐eight community‐dwelling elderly (191 women/187 men). Intervention: Participants were randomly assigned to receive 1 μg of alfacalcidol or matched placebo daily for 36 weeks. Measurements: Serum 25‐hydoxyvitamin D 3 (25(OH) D,1,25‐dihydroxyvitamin D 3 (D‐hormone), and intact parathormone (iPTH) levels were measured using radioimmunoassay at baseline and every 12 weeks. Numbers of fallers and falls were assessed using a questionnaire during each study site visit. Dietary calcium intake was assessed at baseline using a food frequency questionnaire. Results: At baseline, participants had, on average, normal vitamin D and D‐hormone serum levels. Over 36 weeks, alfacalcidol treatment was associated with fewer fallers (odds ratio (OR)=0.69, 95% confidence interval (CI)=0.41–1.16) than placebo. In a post hoc subgroups analysis by medians of total calcium intake, this reduction reached significance in alfacalcidol‐treated subjects with a total calcium intake of more than 512 mg/d (OR=0.45, 95% CI=0.21–0.97, P =.042) but not in those who consumed less than 512 mg/d (OR=1.00, 95% CI= 0.47–2.11, P =.998). Alfacalcidol treatment was also, independent of total calcium intake, associated with a significant 37.9% reduction in iPTH serum levels ( P <.0001). No cases of clinically relevant hypercalcemia were observed. Conclusion: Provided a minimal calcium intake of more than 512 mg/d, alfacalcidol treatment significantly and safely reduces number of fallers in an elderly community dwelling population.