Zurich Disability Prevention Trial (ZDPT)
Monthly Vitamin D to Improve Vitamin D Status and Maintain Function in Pre-frail Older Individuals Living at Home
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
We propose a double-blind, randomized controlled trial to test the effectiveness of a
- Active I (n=70): monthly high-dose vitamin D3 supplement dose (60'000 IU/month, equivalent to 2000 IU daily),
- Active II (n=70): or a monthly standard vitamin D3 supplement dose combined with 25(OH)D (24'000 IU/month, equivalent to 800 IU daily PLUS 300 mcg 25(OH)D, equivalent to 10 mcg per day)
- Control (n=70): compared to a standard vitamin D3 supplement dose (24'000 IU/month, equivalent to 800 IU daily)
All individuals will be advised to consume calcium from natural food sources in a daily dose of 600-800 mgs a day, including milk products. Maximal intake of supplemental calcium is restricted to 250 mg per day.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
ZH
-
Zurich, ZH, Switzerland, 8091
- University Hospital Zurich, Centre on Aging and Mobility
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria:
- Age 70+
- Fall in the last 12 months before screening (with or without a fracture)
- Living at home (community-dwelling)
- Men or women
- Mobile with or without walking aid - have to be able to use public transportation to attend the clinical visits at the trial centre
- Score of at least 27 at the screening Folstein Mini Mental test + normal clock test
- Patient understands the study procedures, alternative treatments available and risks involved with the study, and voluntarily agrees to participate by giving a written informed consents.
- Patient meets the entry minimal requirements based on routine clinical laboratory safety screening tests and the Folstein mini mental status (score 27+ required) performed at the Screening Visit.
- Patient is willing to perform all study tests, attend all required office visits, and provide blood and urine samples.
Exclusion criteria:
- Serum calcium adjusted for albumin of > 2.6 nmol/l
- Pathologic fracture in the last year (except for fractures due to osteoporosis)
- Chemo therapy / Radiation due to cancer in the last year
- Treatment which has an effect on bone metabolism (e.g. bisphosphonate, PTH, calcitonin, chronic cortisone intake > XYmg/day for more than XY month/years (except for inhalation and sporadic infiltration))
- Oral vitamin D intake of more than 800 IU per day
- Unwilling to stop calcium supplementation and vitamin D supplementation during the trial (maximal calcium supplement intake 250mg/d; no additional vitamin D supplementation)
- Severe visual or hearing impairment
- Unwilling or unable to take study medication
- Diseases with a risk of recurrent falling (e.g. Parkinson's disease/syndrome, Hemiplegia after stroke, symptomatic stenosis of the spinal canal, polyneuropathy, epilepsy, recurring vertigo, recurring syncope)
- BMI >= 40
- Estimated creatinine clearance < 15 ml/min (estimated Creatinine Clearance Cockcroft and Gault)
- Malabsorption syndrome (celiac diseases, inflammatory bowl disease)
- Diseases that may enhance serum calcium: sarcoidosis, lymphoma, primary hyperparathyroidism
- kidney stone in the last 10 years
- Abnormal indices of calcium metabolism, uncontrolled hypocalcemia.
- Patient heavily consumes alcohol containing products defined as greater than (>) 3 drinks (beer, wine, or distilled spirits) of alcoholic beverages per day.
- Patient is unlikely to adhere to the study procedures, to keep appointments, or is planning to relocate during the study.
- Patients who are planning a stay in a "sunny" location (e.g. winter sun resort) for more than two months per year
- Medication which has an effect on 25-hydroxyvitamin D level (e.g. certain anticonvulsants (e.g. Phenobarbital, Carbamazepin, Phenytoin))
- M. Paget (Ostitis deformans)
- inflammatory arthritis (e.g. rheumatoid arthritis, reiter syndrome, psoriasis arthritis)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: High-dose vitamin D3
monthly high-dose vitamin D3 supplement dose (60'000 IU/month, equivalent to 2000 IU daily)
|
60000 vitamin D3 orally and once per month
24000 Vitamin D3 orally and once per month
|
|
Experimental: standard vitamin D + 25(OH)D
standard vitamin D3 supplement dose combined with 25(OH)D (24'000 IU/month, equivalent to 800 IU daily PLUS 300 mcg 25(OH)D, equivalent to 10 mcg per day)
|
24000 IU vitamin D3 orally and once per month plus 300 mcg 25(OH)D orally and once per month
|
|
Active Comparator: standard vitamin D
standard vitamin D3 supplement dose (24'000 IU/month, equivalent to 800 IU daily)
|
60000 vitamin D3 orally and once per month
24000 Vitamin D3 orally and once per month
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
functional decline (proportion of individuals with functional decline based on binary repeated measure assessment across 4 lower extremity tests)
Time Frame: 6 and 12 months
|
6 and 12 months
|
|
Improving 25-hydroxyvitamin D levels in late winter and late summer - Percent of individuals reaching desirable 25-hydroxyvitamin D levels of at least 75 nmol/l in late winter and in late summer
Time Frame: 6 and 12 months
|
6 and 12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Safety at baseline, 2 weeks, 6 months, 12 months • Serum calcium adjusted for albumin • Serum creatinine • Urinary calcium/creatinine ratio
Time Frame: 2 weeks, 6 months, 12 months
|
2 weeks, 6 months, 12 months
|
|
Balance/Gait while walking combined with a cognitive task
Time Frame: 12 months
|
12 months
|
|
Short Physical Performance Test Battery
Time Frame: 6 months, 12 months
|
6 months, 12 months
|
|
Timed 4 m walk
Time Frame: 6 months, 12 months
|
6 months, 12 months
|
|
Musculoskeletal pain assessed with the McGill pain map
Time Frame: 6 months and 12 months
|
6 months and 12 months
|
|
systolic and diastolic blood pressure, heart rate
Time Frame: 6 month and 12 months
|
6 month and 12 months
|
|
Rate of falls, all, injurious falls (diary, monthly phone calls, and hotline)
Time Frame: 12 months
|
12 months
|
|
grip strength
Time Frame: 6 months and 12 months
|
6 months and 12 months
|
|
Bone density at the spine and hip, whole body
Time Frame: 6 months and 12 months
|
6 months and 12 months
|
|
incident vertebral fractures (iDXA morphometry)
Time Frame: 12 months
|
12 months
|
|
muscle mass, incident sarcopenia
Time Frame: 6 and 12 months
|
6 and 12 months
|
|
Health care utilization: in collaboration with insurance companies for outpatient and inpatient health care costs.
Time Frame: 12 months
|
12 months
|
|
Quality of life (SF 12 / EuroQuol)
Time Frame: 6 months and 12 months
|
6 months and 12 months
|
|
Rate of hospital admission (fall-related injury, infections, other)
Time Frame: 12 months
|
12 months
|
|
Serum N-telopeptides and other markers of bone remodeling
Time Frame: 6 months and 12 months
|
6 months and 12 months
|
|
Upper and lower respiratory tract infections, any infections, infections that lead to inpatient care
Time Frame: 12 months
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Heike Bischoff Ferrari, MD, MPH, University Hospital Zurich, Centre on Aging and Mobility
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- KEK39/09
- 2009DR2248 (Other Identifier: Swissmedic (Swiss Agency for Therapeutic Products))
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