Huang Xiaoting, Chua Kenneth Wei De, Moh Shirlene Pei Shi, Yuen Heng Wai, Low David Yong Ming, Anaikatti Poongkulali, Iqbal Arshad, Rosario Barbara Helen
Department of Geriatric Medicine, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
Department of Ear Nose and Throat, Changi General Hospital, Singapore, Singapore.
Aging Clin Exp Res. 2025 Feb 22;37(1):43. doi: 10.1007/s40520-025-02938-4.
Benign Paroxysmal Positional Vertigo (BPPV) is the commonest cause of vertigo in older adults. Due to its high incidence in older adults presenting with falls, vestibular assessment is recommended in the World Guidelines for Falls Prevention. There is a paucity of evidence in well conducted randomised controlled trials (RCTs) to evaluate vitamin D for prevention of BPPV recurrence in relation to falls and function.
Primary outcome: does vitamin D supplementation and dietary interventions in combination with standard care impact falls, fear of falling and function in patients with BPPV.
Post hoc analyses of phase IIa single centre, placebo controlled, double blind RCT evaluating vitamin D supplementation with diet and Canalith Repositioning Procedure (CRP) [Group A] versus diet alone with CRP [Group B] in reducing BPPV recurrence rates and the consequent effects on falls and function.
53 participants were recruited. 14 were vitamin D replete at baseline (Group C) with remaining 39 randomised into Groups A and B. Group A had better 5x sit to stand time and 0.75 fewer clinical BPPV recurrences per one person year (P = 0.035) compared to Group B. 25% of participants who fell reported fear of falling compared to 43% in those without falls in the 12 month follow up.
Vitamin D supplementation alongside standard BPPV improved 5xchair stand test and reduced BPPV recurrence. Participants without an incident fall during follow up experience fear of falling, prompting further consideration.
Vitamin D replacement was associated with fewer BPPV recurrences and improved function assessed with 5x chair stand test.
良性阵发性位置性眩晕（BPPV）是老年人眩晕最常见的原因。由于其在跌倒的老年人中发病率较高，《世界预防跌倒指南》建议进行前庭评估。在设计良好的随机对照试验（RCT）中，缺乏证据来评估维生素D预防BPPV复发与跌倒和功能的关系。
主要结局：维生素D补充剂和饮食干预与标准护理相结合是否会影响BPPV患者的跌倒、跌倒恐惧和功能。
对一项IIa期单中心、安慰剂对照、双盲RCT进行事后分析，该试验评估了饮食补充维生素D联合耳石复位程序（CRP）[A组]与单纯饮食联合CRP[B组]对降低BPPV复发率以及对跌倒和功能的后续影响。
招募了53名参与者。14名在基线时维生素D充足（C组），其余39名随机分为A组和B组。与B组相比，A组的5次坐立时间更好，每人每年临床BPPV复发次数少0.75次（P = 0.035）。在12个月的随访中，跌倒的参与者中有25%报告有跌倒恐惧，而未跌倒的参与者中这一比例为43%。
在标准BPPV治疗基础上补充维生素D改善了5次坐立试验结果并降低了BPPV复发率。随访期间未发生跌倒事件的参与者也有跌倒恐惧，这促使进一步思考。
维生素D替代治疗与较少的BPPV复发相关，并通过5次坐立试验评估改善了功能。
