Dataset Information

Effect of Vitamin K2 on Postural Sway in Older People Who Fall: A Randomized Controlled Trial.

ABSTRACT: OBJECTIVES:Vitamin K is thought to be involved in both bone health and maintenance of neuromuscular function. We tested the effect of vitamin K2 supplementation on postural sway, falls, healthcare costs, and indices of physical function in older people at risk of falls. DESIGN:Parallel-group double-blind randomized placebo-controlled trial. SETTING:Fourteen primary care practices in Scotland, UK. PARTICIPANTS:A total of 95 community-dwelling participants aged 65 and older with at least two falls, or one injurious fall, in the previous year. INTERVENTION:Once/day placebo, 200 ?g or 400 ?g of oral vitamin K2 for 1 year. MEASUREMENTS:The primary outcome was anteroposterior sway measured using sway plates at 12?months, adjusted for baseline. Secondary outcomes included the Short Physical Performance Battery, Berg Balance Scale, Timed Up & Go Test, quality of life, health and social care costs, falls, and adverse events. RESULTS:Mean participant age was 75 (standard deviation [SD] = 7) years. Overall, 58 of 95 (61%) were female; 77 of 95 (81%) attended the 12-month visit. No significant effect of either vitamin K2 dose was seen on the primary outcome of anteroposterior sway (200 ?g vs placebo: -.19?cm [95% confidence interval [CI] -.68 to .30; P = .44]; 400 ?g vs placebo: .17?cm [95% CI -.33 to .66; P = .50]; or 400 ?g vs 200 ?g: .36?cm [95% CI -.11 to .83; P = .14]). Adjusted falls rates were similar in each group. No significant treatment effects were seen for other measures of sway or secondary outcomes. Costs were higher in both vitamin K2 arms than in the placebo arm. CONCLUSION:Oral vitamin K2 supplementation did not improve postural sway or physical function in older people at risk of falls. J Am Geriatr Soc 67:2102-2107, 2019.

SUBMITTER: Witham MD

PROVIDER: S-EPMC6851824 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Effect of Vitamin K2 on Postural Sway in Older People Who Fall: A Randomized Controlled Trial.

Witham Miles D MD Price Rosemary J G RJG Band Margaret M MM Hannah Michael S MS Fulton Roberta L RL Clarke Clare L CL Donnan Peter T PT McNamee Paul P Cvoro Vera V Soiza Roy L RL

Journal of the American Geriatrics Society 20190618 10

<h4>Objectives</h4>Vitamin K is thought to be involved in both bone health and maintenance of neuromuscular function. We tested the effect of vitamin K2 supplementation on postural sway, falls, healthcare costs, and indices of physical function in older people at risk of falls.<h4>Design</h4>Parallel-group double-blind randomized placebo-controlled trial.<h4>Setting</h4>Fourteen primary care practices in Scotland, UK.<h4>Participants</h4>A total of 95 community-dwelling participants aged 65 and ...[more]

PMID: 31211416

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Project description:Background and Purpose:Fall accidents are a social challenge in Korea and elsewhere. Most previous studies have focused on the effects of reduced visual acuity due to myopia on falls and body balance. The objective of this study was to investigate whether uncorrected hyperopia was a major risk factor for falls and to establish whether the risk of falls was absolutely correlated with visual acuity. Methods:Fifty-one young subjects with a mean age of 22.75 ± 2.13 years were enrolled in this study. To induce hyperopic and myopic refractive errors, spherical lenses of ±1.0-6.0 D (1.0 D stepwise) were used. Under each induced condition, fall risk index and sway power were assessed via Fourier transformation of postural sway using a TETRAX system. Results:The fall risk index for eyes-closed was significantly greater than that of eyes-open with full correction (t = -5.876, p < 0.05). The fall risk index increased significantly from hyperopia induced with -4.0 D lenses (with visual acuity of 0.69 ± 0.32) compared to eyes-open with full correction (F = 3.213, p < 0.05). However, there was no significant change in the induced myopia conditions, despite a drastic decline in decimal visual acuity. Sway power increased significantly in the low-to-medium frequency band derived from the peripheral vestibular system when hyperopia was induced. A significant difference was detected in hyperopia induced with -6.0 D lenses compared to eyes-open with full correction (F = 4.981, p = 0.017). Conclusion:An uncorrected hyperopia rather than myopia may increase the risk of falls, although eyes may show normal visual acuity due to the inherent accommodation mechanism. Our findings suggest that the corrected state of refractive errors is more important than the level of visual acuity as the criteria for appropriate visual input, which contributes to stable posture. Therefore, clinicians should consider the refractive condition, especially the characteristics of hyperopia, when analyzing body balance, and appropriate correction of uncorrected hyperopia to prevent falls.

Project description:BackgroundVitamin D insufficiency is common in older people and may lead to increased bone resorption, bone loss, and increased falls and fractures. However, clinical trials assessing the effect of vitamin D supplementation on bone mineral density (BMD) have yielded conflicting results.ObjectivesThis study examined the effect of vitamin D supplementation on BMD at the hip, using dual-energy X-ray absorptiometry.MethodsA total of 379 adults aged ≥70 y (48% women; mean age: 75 y) from the northeast of England were randomly allocated to 1 of 3 doses of vitamin D3 [12,000 international units (IU), 24,000 IU, or 48,000 IU] given once a month. The primary outcome was change in BMD (ΔBMD) at the hip. Secondary endpoints comprised the dose effects on femoral neck BMD, falls, circulating calciotropic hormones, bone turnover markers, and adverse events.ResultsThe mean ± SD baseline plasma 25-hydroxyvitamin D [25(OH)D] concentration was 40.0 ± 20.1 nmol/L, which increased after 12 mo to a mean 25(OH)D of 55.9, 64.6, or 79.0 nmol/L for participants receiving a monthly dose of 12,000, 24,000, or 48,000 IU, respectively (P < 0.01 for difference). There was no between-group difference in ΔBMD. However, parathyroid hormone concentrations decreased in all 3 groups, with a significantly greater decrease in the 48,000-IU group compared with the 12,000-IU group (P < 0.01). There were no differences in any adverse events between groups, with 3 cases of hypercalcemia, none of nephrolithiasis, and 249 falls observed.ConclusionsThere was no difference in change in BMD over 12 mo between the 3 doses of vitamin D, suggesting no effect of the intervention or a similar attenuation of the anticipated decrease in BMD over 12 mo. The treatment was safe and effective in increasing plasma 25(OH)D concentrations, with no dose-related adverse events. This trial was registered at the EU Clinical Trials Register (EudraCT 2011-004890-10) and the ISRCTN Registry (ISRCTN35648481).

Project description:BACKGROUND:Diminished somatosensory function is a critical age-related change which is related to postural instability in the older population. Footwear is a cost-effective way to modulate the postural stability by altering sensorimotor inputs via mechanoreceptors on the plantar surface of the feet. Compared to insoles with indentions in the entire surface, we innovatively developed a textured insole with site-specific nodulous protrudous. This study thus aimed to investigate the immediate effect of the nodulous insole and supporting surface condition on static postural stability and lower limb muscle activation for healthy older women. METHODS:This is a single-session study with repeated measurements. Twenty-three healthy older women stood on the firm (i.e., concrete floor) and foam surfaces with their eyes open in the three footwear conditions, namely barefoot, plain shoes and shoes with an innovative textured insole, for 30 seconds. Static postural sway and muscle activation of biceps femoris (BF), vastus lateralis (VL), tibialis anterior (TA), and lateral gastrocnemius (LG) of the dominant leg were measured during each testing condition. RESULTS:Compared to a firm surface, standing on the foam could significantly increase the body sway and lower limb muscle activation (p<0.05). When standing on the foam, compared to barefoot, wearing footwear significantly decreased the VL and TA muscle activation and minimize the postural sway in medial-lateral and anterior-posterior direction, while the influence is larger for the shoes with nodulous insloe compared to the plain shoes. No significant differences between the footwear conditions for static stability and muscle activation were observed on firm surface condition. CONCLUSIONS:For older women, footwear could improve the postural stability in the unstable surface, particularly the footwear with nodulous insole, with the underlying mechanism as enhancing the mechanoreceptors on the plantar surface of the feet.

Dataset Information

Effect of Vitamin K2 on Postural Sway in Older People Who Fall: A Randomized Controlled Trial.

Publications

Effect of Vitamin K2 on Postural Sway in Older People Who Fall: A Randomized Controlled Trial.

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