The Prevention of Hip Fracture with Menatetrenone and Risedronate Plus Calcium Supplementation in Elderly Patients with Alzheimer Disease: A Randomized Controlled Trial
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概要
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A high incidence of fractures, particularly of the hip, represents an important problem in patients with Alzheimer disease (AD), who are prone to falls and have osteoporosis. We previously found that vitamin K deficiency and low 25-hydroxyvitamin D (25-OHD) with compensatory hyperparathyroidism cause reduced bone mineral density (BMD) in female patients with AD. This may modifiable by intervention with menatetrenone (vitamin K2) and risedronate sodium; we address the possibility that treatment with menatetrenone, risedronate and calcium may reduce the incidence of nonvertebral fractures in elderly patients with AD. A total of 231 elderly patients with AD were randomly assigned to daily treatment with 45 mg of menatetrenone or a placebo combined with once weekly risedronate sodium, and followed up for 12 months. At baseline, patients of both groups showed high undercarboxylated osteocalcin (ucOC) and low 25-OHD insufficiency with compensatory hyperparathyroidism. During the study period, BMD in the treatment group increased by 5.7% and increased by 2.1% in the control group. Nonvertebral fractures occurred in 15 patients (10 hip fractures) in the control group and 5 patients (2 hip fractures) in the treatment group. The relative risk in the treatment group compared with the control group was 0.31 (95% confidence interval, 0.12-0.81). Elderly AD patients with hypovitaminosis K and D are at increased risk for hip fracture. The study medications were well tolerated with relatively few adverse events and effective in reducing the risk of a fracture in elderly patients with AD.
著者
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HONDA Yoshiaki
Department of Chemistry,Faculty of Science,Tokyo Metropolitan University
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TAKEDA Tsuyoshi
Institute for Integrated Sports Medicine, Keio University School of Medicine
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Iwamoto Jun
Institute For Integrated Sports Medicine Keio University School Of Medicine
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Takeda Tsuyoshi
Institute For Integrated Sports Medicine Keio University School Of Medicine
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Matsumoto Hideo
Institute For Integrated Sports Medicine Keio University
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Sato Yoshihiro
Department of Neurology, Mitate Hospital
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Sato Yoshihiro
Department of Applied Biological Science, Tokyo University of Science
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UMENO KAZUO
Department of Neuropsychiatry, Mitate Hospital
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HAYASHIDA NORIMASA
Department of Neuropsychiatry, Mitate Hospital
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