Fall Prevention by Alfacalcidol and Training (SPALT)

Inclusion Criteria:

• Men and women who are 65 years of age or older
• Personal history of at least one movement-related, non-syncopal fall, either within the past year OR earlier with additional findings of an increased fall risk during screening examination.
• Creatinine-clearance of 30 to 60 ml/min equivalent to a moderately impaired kidney function (stage 3) according to the classification of the Kidney Disease Outcomes Quality Initiative (K/DOQI) of the National Kidney Foundation (NKF).

Exclusion Criteria:

• Immobility with inability to go out and participate in training course
• History of a fracture or of a stroke provided the event has occurred in the last 3 months
• Presence of a physical or mental disorder that has led to a set-up or to a planned set-up for a statutory care
• Severe dementia
• Severe disorder of speech or comprehension
• Disease that rules out participation during the intervention period or that would deteriorate as a result of type of intervention (e.g. absorptive hypercalciuria, nephrocalcinosis, calcium containing renal calculi or hypophosphataemia)
• Hypersensitivity (allergy) to Alfacalcidol, groundnuts, groundnut oil or Soya
• Vitamin-D hypersensitivity or -intoxication
• Simultaneous intake of vitamin D and its derivatives.
• Participation in any other clinical trial, that is still ongoing or has been completed less than 3 months prior date of intended inclusion
• Substitution of more than 500 mg calcium per day
• Planned medical therapy during the period of intervention that requires long-term suspension of intervention.
• Presence of hypercapnia of over 2.6mmol/l, calcium x phosphate product of over 3.7 (mmol/l)2 and alkalosis with venous blood-pH- reading of over 7.44 (milk-alkali-syndrome, Burnett syndrome)
• Hypercalcaemia (e.g. as a result of hyperparathyroidism, an overdose of vitamin D, paraneoplastic syndrome, osseous metastases, sarcoidosis, Boeck´s disease, osteoporosis induced by immobilisation) or hypermagnesemia according to normative values of the engaged laboratory
• Hereditary fructose intolerance
• Commitment into an institution