Institute of Gerontology, J. F. Oberlin University, 3758 Tokiwa-machi, Machida, 194-0294, Tokyo, Japan.
Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
J Bone Miner Metab. 2020 Nov;38(6):859-867. doi: 10.1007/s00774-020-01118-w. Epub 2020 Jul 27.
Older people aged over 75 are more prone to falls because physical functions become deteriorated along with aging, and also fracture risk is strongly correlated with age. We evaluated the effects of anti-osteoporosis agents, eldecalcitol (ELD) and alendronate (ALN) on physical functions by assessing dynamic and static postural balance in aged patients with osteoporosis.
A randomized, open-label, controlled clinical trial has been conducted with 124 female patients aged 65 or over with osteoporosis. Patients were randomly assigned to receive either 0.75 μg of ELD once-a-day or 35 mg of ALN once-a-week for 24 weeks. The primary endpoint was the change in a postural balance index, adjusted composite equilibrium score (CES) of sensory organization test (SOT). The SOT equilibrium scores, leg muscle strength, and other physical functions were also evaluated.
The Adjusted CES increased from baseline by 6.10% in the ELD group and 6.28% in the ALN group. There was no statistically significant difference between the two groups. The static postural balance at fixed platform were maintained in the ELD group, but declined in the ALN group. The dynamic postural balance at swaying platform and knee extension power increased from baseline in both groups.
These results suggest that ELD and ALN treatments may each be beneficial to improve postural balance control in older patients with osteoporosis via different mechanisms of action.
75 岁以上的老年人更容易摔倒，因为随着年龄的增长，身体机能会恶化，而且骨折风险与年龄密切相关。我们通过评估骨质疏松症老年患者的动态和静态姿势平衡来评估抗骨质疏松药物艾地骨化醇（ELD）和阿仑膦酸钠（ALN）对身体功能的影响。
对 124 名 65 岁或以上的女性骨质疏松症患者进行了一项随机、开放标签、对照临床试验。患者被随机分为每天一次接受 0.75μg ELD 或每周一次接受 35mg ALN 治疗 24 周。主要终点是姿势平衡指数、感觉组织测试（SOT）调整后的综合平衡评分（CES）的变化。还评估了 SOT 平衡评分、腿部肌肉力量和其他身体功能。
ELD 组的调整后 CES 从基线增加了 6.10%，ALN 组增加了 6.28%。两组之间没有统计学上的显著差异。ELD 组在固定平台上的静态姿势平衡得到维持，而 ALN 组则下降。在摆动平台和膝关节伸展力量方面，两组的动态姿势平衡均从基线开始增加。
这些结果表明，ELD 和 ALN 治疗可能通过不同的作用机制对改善骨质疏松症老年患者的姿势平衡控制都有益处。
