Abstract
Purpose:
In an open observational prospective multicentered study on a cohort of patients with
a creatinine clearance of ≤ 65 ml/min and diagnosed with the “Esslinger Fall Risk
Assessment” to be at an increased risk for falls the effect of daily treatment with
1 µg alfacalcidol (CAS 41294-56-8; Alpha-D3) on muscle power, balance and number of fallers and falls was investigated.
Methods:
In this open prospective study on 237 participants recruited in Germany, 16.9% men
and 83.1% women with a mean age of 75.9 years and a mean body mass index (BMI) of
26.3 kg/m2 underwent at the beginning and after 3 and 6 months different muscle strength and
balance tests such as the Timed-up and Go Test (TUG), the Tandem Stand Test (TST)
and the Chair Rising Test (CRT). A successful performance in these tests has been
associated with a significantly lower risk for falls and non-vertebral fractures in
elderly patients (successful test performance: TUG < 12 s, TST > 10 s, CRT < 10 s).
Results:
Controlled for age, gender and BMI, treatment with alfacalcidol was associated with
a significantly increased performance in all three muscle and balance tests already
after 3 months. This effect increased after six months of therapy and a significant
increase in the number of participants who were able to successfully perform the different
tests was observed: plus 74.9% for the TUG (p < .0001), plus 112% for the TST (p <
.0001) and plus 108% for the CRT (p < .0001). After six months the mean time used
for the TUG was decreased by 2.01 s, by 2.29 s for the CRT, and increased by 2.02
s for the TST.
Controlled for age, gender, BMI and CrCl, treatment with alfacalcidol for six months
resulted in a significant 48.1% (p < .0001) decrease in the absolute number of fallers
and a significant 51.3% (p < .0001) decrease in the absolute number of falls, compared
to the 6 months prior to alfacalcidol therapy.
Conclusions:
Treatment with alfacalcidol increases muscle power and balance as measured with three
different muscle power and balance tests and leads to a highly significant decrease
in the number of fallers and falls.
Key words
Alfacalcidol - Balance - CAS 41294-56-8 - Creatinine clearance - Falls and fractures
- Muscle power