Accidental Falls Clinical Trial
Every year, nearly 30% of people aged over 65 fall at least once and about 15% fall at least
twice. These falls can have serious consequences that are a significant threat to the
independence and well-being of older people. From an economic perspective, the cost of
medical care related to falls and resulting injuries is very high and continue to grow with
the aging of the population. Therefore falls prevention is a public health priority.
Many data suggest that cognitive, common disorders in the elderly, is a major risk factor
for falls and the elderly often have difficulty managing their parallel postural stability
and other situations requiring attentional resources. Furthermore, the data used to evoke a
role of vitamin D in the risk of falls in the elderly. Indeed, vitamin D has beneficial
effects on muscle and on the human brain and several recent studies have shown the existence
of positive relationship between serum 25 hydroxyvitamin D and cognitive function. These
different actions may explain the beneficial effect of vitamin D supplementation on the risk
of falling for practicing daily oral doses of vitamin D in the range of 700-1000 IU.
Our goal in this study is to confirm the existence of a link between vitamin D status and
some areas of cognitive functions, and analyze the roles played by vitamin D deficiency and
cognitive impairment in the occurrence of falls. The study will also seek the existence of a
threshold level of 25-hydroxyvitamin D below which may arise cognitive disorders. The
prospective follow-up of patients for 2 years will study the effect of correcting the
vitamin D deficiency (initial correction and regular supplementation) on cognitive function,
balance, walking and the occurrence of falls.
The study will be conducted in 150 subjects aged 50 years and over and fell in 150 subjects
aged 50 and over at risk of falling. These patients will be enrolled in the Emergency
Services, Orthopedics, Geriatrics, and Rheumatology of the University Hospital of Caen. All
subjects will receive a dose of 25 hydroxyvitamin D, a comprehensive study of cognitive
function, tests of balance and walking and assessment of activities of daily living and
depression. All the examinations and tests will be carried out during the same half day.
According to current recommendations, it will be prescribed a treatment with Vitamin D to
subjects with a lowered rate of 25 hydroxyvitamin D (<30 ng / ml) to normalize the rate and
will be advised doctors to prescribe regular supplementation vitamin D in order to maintain
it in the standard rate (30 to 80 ng / ml). The effect of the correction of hypovitaminosis
D, confirmed by controlling the rate of 25 hydroxyvitamin D, on cognitive functions, balance
and walking will be analyzed 3 months and 9 months. During the two years following their
inclusion in the study, subjects will be contacted by a phone call every 3 months during
which will be recorded any falls they have been victims, as well as changes to their drug
treatments, particularly case of regular intake of vitamin D supplementation.
If our hypothesis were true, it would be appropriate to consider a new approach to
prevention of fractures involving the correction of vitamin D deficiency, cognitive
rehabilitation and cognitive-motor drive in subjects with cognitive impairment.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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