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Non-Drug Treatment of Osteoporosis Research
Despite the fact that most osteoporotic fractures are related to a fall, little research to date has focused on fall prevention strategies as they may relate to fractures. Non-drug approaches to prevent falls and fractures are appealing given the concerns of polypharmacy and non-compliance in the elderly. Researchers in the musculoskeletal center are involved in several non-drug studies that may prevent future falls and/or fractures:
- VIBES - Vibration to Improve Bone in Elderly Subjects is an NIH-funded, double blind, placebo controlled trial of seniors with osteoporosis who are randomized to 10 minutes per day of low magnitude mechanical stimulation through the use of a vibrating platform versus a placebo platform. This study will enroll 200 seniors living in independent living communities around the Boston area. The primary outcome is computed tomography (CT) scans of the hip and spine. Secondary outcomes include biochemical markers of bone turnover, balance, strength and fall incidence.
- HipPro Study - Prior studies of hip protectors have been limited in their ability to draw conclusions based on low adherence and limitations in study design (i.e. cluster randomization). This study was a multi-institutional randomized, control trial that allocated nursing home residents to either a right or left sided hip protector. Despite good adherence with the intervention, there was no reduction in hip fractures among protected hips. Future studies of hip protectors should include the testing of alternative types of hip protectors in their study design.
- Vitamin D - Vitamin D deficiency is common in the elderly, and it has been associated with low bone mineral density and falls. This study was a randomized, placebo control trial to determine the effect of varying doses of vitamin D among nursing home residents. Residents receiving at least 800IU of vitamin D daily had a decreased risk of falls compared with residents receiving lesser doses.
- Medication changes - Medication changes may be one of the most common, and potentially modifiable risk factors for falls in the nursing home setting. This ongoing study will determine the effects of a medication change on the acute risk of falls among nursing home residents. Identification of acute risk factors for falls could lead to the development and testing of more successful fall intervention strategies in the nursing home setting.
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