Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of more than 500 mg daily

J Am Geriatr Soc. 2004 Feb;52(2):230-6. doi: 10.1111/j.1532-5415.2004.52060.x.


Objectives: To study the effect of alfacalcidol (1alpha(OH)D3) on fall risk in community-dwelling elderly men and women.

Design: Randomized, double-blind, placebo-controlled intervention trial.

Setting: Basel, Switzerland.

Participants: Three hundred seventy-eight community-dwelling elderly (191 women/187 men).

Intervention: Participants were randomly assigned to receive 1 microg of alfacalcidol or matched placebo daily for 36 weeks.

Measurements: Serum 25-hydoxyvitamin D3 (25(OH) D,1,25-dihydroxyvitamin D3 (D-hormone), and intact parathormone (iPTH) levels were measured using radioimmunoassay at baseline and every 12 weeks. Numbers of fallers and falls were assessed using a questionnaire during each study site visit. Dietary calcium intake was assessed at baseline using a food frequency questionnaire.

Results: At baseline, participants had, on average, normal vitamin D and D-hormone serum levels. Over 36 weeks, alfacalcidol treatment was associated with fewer fallers (odds ratio (OR)=0.69, 95% confidence interval (CI)=0.41-1.16) than placebo. In a post hoc subgroups analysis by medians of total calcium intake, this reduction reached significance in alfacalcidol-treated subjects with a total calcium intake of more than 512 mg/d (OR=0.45, 95% CI=0.21-0.97, P=.042) but not in those who consumed less than 512 mg/d (OR=1.00, 95% CI= 0.47-2.11, P=.998). Alfacalcidol treatment was also, independent of total calcium intake, associated with a significant 37.9% reduction in iPTH serum levels (P<.0001). No cases of clinically relevant hypercalcemia were observed.

Conclusion: Provided a minimal calcium intake of more than 512 mg/d, alfacalcidol treatment significantly and safely reduces number of fallers in an elderly community dwelling population.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data
  • Adjuvants, Immunologic / pharmacology
  • Adjuvants, Immunologic / therapeutic use*
  • Aged
  • Calcitriol* / blood
  • Calcium / administration & dosage
  • Calcium / blood
  • Double-Blind Method
  • Female
  • Humans
  • Hydroxycholecalciferols / pharmacology
  • Hydroxycholecalciferols / therapeutic use*
  • Male
  • Multivariate Analysis
  • Parathyroid Hormone / blood
  • Prodrugs / pharmacology
  • Prodrugs / therapeutic use*
  • Statistics, Nonparametric


  • Adjuvants, Immunologic
  • Hydroxycholecalciferols
  • Parathyroid Hormone
  • Prodrugs
  • Calcitriol
  • Calcium
  • alfacalcidol