Citation

Gallagher JC, Rapuri PB, Smith LM. J. Clin. Endocrinol. Metab. 2006; 92(1): 51-58.

Affiliation

Bone Metabolism Unit, Creighton University Medical Center, School of Medicine, Omaha. Department of Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha.

Copyright

(Copyright © 2006, Endocrine Society)

DOI

10.1210/jc.2006-1153

PMID

17032712

PMCID

PMC1892155

Abstract

Context: Decreased calcitriol production due to impaired renal function may be a significant risk factor for falls in normal aging population. Objective: To examine the association between creatinine clearance (CrCl) and the incidence of falls and fallers in groups treated with placebo, calcitriol, hormone therapy (ET/HT) and calcitriol+ET/HT. Design: 3 yr double blind placebo controlled study designed to test the efficacy of calcitriol and ET/HT on bone loss and falls. Analysis by intention to treat and post hoc. Setting: Academic outpatient center. Participants: 489 normal elderly women aged 65-77 yr. 415 women completed the study. Intervention: Subjects were randomized to placebo, calcitriol 0.25mcg bid, ET/HT daily (conjugated equine estrogens 0.625 mg with or without medroxyprogesterone acetate 2.5 mg) and calcitriol+ET/HT. Main outcome measures: Cumulative number of falls and fallers were compared between groups with 24 h urine CrCl<60 and >/=60ml/min. Results: Calcitriol treatment decreased the number of fallers and falls. Low CrCl<60ml/min was a predictor of the number of falls per person but not fallers in the placebo group (P = 0.007). In the low CrCl group (<60ml/min), the rate of falls decreased on calcitriol by 53 percent (95%CI: -71% to -22%; P = 0.003), on calcitriol +ET/HT by 61 percent (95%CI: -76% to -37%; P = 0.001) and on ET/HT by 25 percent (95%CI: -55% to +24%; not significant). Calcitriol reduced the rate of falls by 30% (95%CI: -49% to -4%; P = 0.027) in the CrCl>/=60ml/min group. Conclusion: Calcitrioltreatment decreases falls in all subjects but especially in elderly women with decreased renal function (<60ml/min) and in frequent fallers.

Language: en