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Study To Understand Fall Reduction and Vitamin D in You (STURDY)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02166333
Recruitment Status : Terminated
First Posted : June 18, 2014
Results First Posted : May 14, 2021
Last Update Posted : May 14, 2021
Sponsor:
Collaborator:
National Institute on Aging (NIA)
Information provided by (Responsible Party):
Johns Hopkins University

Brief Summary:
Vitamin D supplements might substantially reduce the risk of falls, potentially by more than 25%. The proposed study is a clinical trial that will determine the effects of 4 doses of vitamin D (200 International Units [IU]/day, 1000 IU/day, 2000 IU/d and 4000 IU/d) as a means to prevent falls in high-risk adults, ages 70 and older. Results of this trial will be directly relevant to public health and clinical guidelines, and will immediately influence policy.

Condition or disease Intervention/treatment Phase
Vitamin D Deficiency Falls Dietary Supplement: 200 IU/d cholecalciferol Dietary Supplement: 1000 IU/d cholecalciferol Dietary Supplement: 2000 IU/d cholecalciferol Dietary Supplement: 4000 IU/d cholecalciferol Not Applicable

Detailed Description:

The public health burden of falls in older persons is substantial. Several lines of evidence suggest that vitamin D supplements might reduce the risk of falls, potentially by 25% or more in persons with low serum 25-hydroxyvitamin D [25(OH)D] levels. However, existing evidence is inconsistent and insufficient to guide policy. The trial is a seamless two-stage, Bayesian response-adaptive, randomized dose-finding trial designed to select the best dose of vitamin D supplementation and to potentially confirm the efficacy of that dose for fall prevention and other related outcomes. Participants will be community-dwelling adults, aged 70+ (goal of ~40% black, ~60% women), with a baseline serum 25(OH)D level of 10-29 ng/ml, who are at high risk for falling.

In Stage 1 of the adaptive design, participants will be randomly assigned to one of four vitamin D3 (cholecalciferol) doses: 200 IU/d (control), 1000 IU/d, 2000 IU/d, or 4000 IU/d, with assignment probabilities that will vary as falls are reported. Participants will take their assigned pills for two years, or until the study ends, whichever comes first. This stage of the design will select the best non control dose of vitamin D for prevention of falls, or confirm the futility of distinguishing any differences among the non control doses for fall prevention. If a best dose is selected, subsequent participants will be randomized in Stage 2 of the trial into the comparison (200 IU/d) or best dose group, and all participants (Stage 1 and Stage 2) will continue to be followed to potentially confirm efficacy. The investigators anticipate enrolling approximately 1,200 participants over the entire length of the project.

The primary outcome is time to first fall (or death) over two years of therapy. Next in importance is the outcome of gait speed. Other outcomes include fall rates, types of falls, balance, muscle strength, frailty, Short Physical Performance Battery (SPPB) score, 6-minute walk time, and physical activity assessed by accelerometry. Falls will be ascertained from fall calendars completed daily by participants and from self-report by phone. In-person follow-up visits will occur at 3, 12, and 24 months, with telephone visits occurring at 1, 6, 9, 15, 18, and 21 months after randomization. Subgroups with potential for greater benefit from vitamin D supplementation are blacks, those with baseline 25(OH)D of 10-19 ng/ml, and those with objective evidence of low physical function.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 688 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Prevention
Official Title: Vitamin D Supplements to Prevent Falls in Older Adults: A Dose-Response Trial
Actual Study Start Date : June 30, 2015
Actual Primary Completion Date : May 31, 2019
Actual Study Completion Date : June 7, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Falls Vitamin D

Arm Intervention/treatment
Active Comparator: 200 IU/d
200 IU/d cholecalciferol (vitamin D3) tablets that can be swallowed or consumed sublingually
Dietary Supplement: 200 IU/d cholecalciferol
Other Name: vitamin D3

Active Comparator: 1000 IU/d
1000 IU/d cholecalciferol (vitamin D3) tablets that can be swallowed or consumed sublingually
Dietary Supplement: 1000 IU/d cholecalciferol
Other Name: vitamin D3

Active Comparator: 2000 IU/d
2000 IU/d cholecalciferol (vitamin D3) tablets that can be swallowed or consumed sublingually
Dietary Supplement: 2000 IU/d cholecalciferol
Other Name: vitamin D3

Active Comparator: 4000 IU/d
4000 IU/d cholecalciferol (vitamin D3) tablets that can be swallowed or consumed sublingually
Dietary Supplement: 4000 IU/d cholecalciferol
Other Name: vitamin D3




Primary Outcome Measures :
  1. Incidence of First Fall or Death (Whichever Comes First) [ Time Frame: Randomization to 24 months or end of trial, whichever came first ]
    Falls were ascertained by a monthly fall calendar completed by each participant, scheduled interviews at 1 month and 3 months after randomization and every 3 months thereafter up to 24 months or trial end. Death was ascertained primarily by reports from family or friends.


Secondary Outcome Measures :
  1. Change in Gait Speed [ Time Frame: Baseline, 3 months, 12 months and 24 months ]
    Gait speed in meters per second (m/s) was obtained from the timed 4-meter, usual-paced walk component of the Short Physical Performance Battery. The change in gait speed was obtained as follow-up measure minus baseline measure.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   70 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Age 70 and older
  • Non-institutionalized
  • High risk for falling, defined by a 'yes' response to at least one of the following:
  • 1. Have you fallen and hurt yourself in the past year?
  • 2. Have you fallen 2 or more times in the past year?
  • 3. Are you afraid that you might fall because of balance or walking problems?
  • 4. Do you have difficulty maintaining your balance when bathing, dressing, or getting in and out of a chair?
  • 5. Do you use a cane, walker, or other device when walking inside or outside your home?
  • Serum vitamin D [25(OH)D] level of 10-29 ng/ml
  • Able to provide informed consent
  • Willing to accept randomization to each vitamin D dose
  • One of the following:
  • 1. No vitamin D supplementation at baseline
  • 2. Average daily vitamin D supplementation judged by study staff as being consistent with the goal of 1000 IU/day or less at screening and willing to continue the dose unchanged throughout the trial
  • One of the following:
  • 1. No calcium supplementation at baseline
  • 2. Average daily calcium supplementation judged by study staff as being consistent with the goal of 1200 mg/day or less at screening and willing to continue the dose unchanged throughout the trial

Exclusion Criteria:

  • Cognitive impairment, defined by Mini-Mental State Exam (MMSE) score <24
  • Hypercalcemia, serum Ca++ 11.0 mg/dl or higher or >10.5 mg/dl (confirmed)
  • Hypocalcemia, serum Ca++ <8.5 mg/dl
  • Kidney, ureteral, or bladder stones made of calcium compounds (2 or more in lifetime, or 1 in the last 2 years); in the absence of information on the type of stone, stones will be assumed to be made of calcium compounds
  • Planning to move out of area within 2 years, where plans would prevent compliance with the study protocol
  • Disease or condition expected to cause death or to prevent compliance with the study protocol in the next 2 years
  • Participation in another trial of vitamin D or falls, or any trial that might affect the risk of falls
  • Lactose allergy (lactose intolerance is okay)
  • Use of any form of oral or injected calcitriol (brand names: Rocaltrol (R), Calcijex (R), and Zemplar (R); generic names: calcitriol, paricalcitol, doxycalcitriol, 22-oxacalcitriol)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02166333


Locations
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United States, Maryland
ProHealth Clinical Research Unit
Baltimore, Maryland, United States, 21207
Comstock Center for Public Health Research and Prevention
Hagerstown, Maryland, United States, 21740
Sponsors and Collaborators
Johns Hopkins University
National Institute on Aging (NIA)
Investigators
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Study Chair: Lawrence J Appel, MD, MPH Johns Hopkins University
  Study Documents (Full-Text)

Documents provided by Johns Hopkins University:
Study Protocol  [PDF] May 5, 2017
Statistical Analysis Plan  [PDF] May 26, 2017

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Johns Hopkins University
ClinicalTrials.gov Identifier: NCT02166333    
Other Study ID Numbers: IRB00063914
U01AG047837 ( U.S. NIH Grant/Contract )
First Posted: June 18, 2014    Key Record Dates
Results First Posted: May 14, 2021
Last Update Posted: May 14, 2021
Last Verified: April 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: De-identified participant data and data dictionary will be available at https://archive.data.jhu.edu/ starting one year after publication of the primary outcome results, contingent upon Institutional Review Board (IRB) approval.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Informed Consent Form (ICF)
Time Frame: One year after publication of primary outcome results. Data are expected to be available in December 2021. Data are expected to remain available in perpetuity.
Access Criteria: Data will be available at https://archive.data.jhu.edu/ contingent on IRB approval of their use.
URL: https://archive.data.jhu.edu/
Keywords provided by Johns Hopkins University:
vitamin D
falls
high risk of falling
insufficient or deficient serum vitamin D levels
10-29 ng/ml
Additional relevant MeSH terms:
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Vitamin D Deficiency
Avitaminosis
Deficiency Diseases
Malnutrition
Nutrition Disorders
Vitamin D
Ergocalciferols
Cholecalciferol
Vitamins
Micronutrients
Nutrients
Growth Substances
Physiological Effects of Drugs
Bone Density Conservation Agents
Calcium-Regulating Hormones and Agents