Using vitamin K to improve strength and balance in older people

ISRCTN ISRCTN18436190
DOI https://doi.org/10.1186/ISRCTN18436190
Secondary identifying numbers 2013GR09
Submission date
30/09/2015
Registration date
05/10/2015
Last edited
20/08/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Signs and Symptoms
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Vitamin K plays a vital role in the body by helping blood to clot and preventing excessive bleeding. It typically comes in two forms: vitamin K1, which is found in leafy green vegetables and vitamin K2, which is found in meat, eggs and cheese. Recent studies have shown that vitamin K2 can help to keep bones healthy and may help to prevent muscle weakness. Falls are one of the leading causes of death and injury in people over the age of 65. Although falls can occur for a variety of reasons, balance problems are thought to play an important role. The aim of this trial is to find out whether vitamin K2 supplements can help to improve balance and reduce the risk of falls in older people.

Who can participate?
Adults aged 65 or over with a history of falls over the last year.

What does the study involve?
Participants are randomly allocated into three groups. The first group take a 400mcg vitamin K2 tablet once a day for 12 months; the second group take a 200mcg vitamin K2 tablet once a day for 12 months and the third group take a placebo tablet (dummy pill) once a day for 12 months. At the end of the 12 months, the balance of all participants is measured at a follow-up appointment by seeing the amount that they sway forwards and backwards on a balance board. At this appointment, participants also have a sample of blood taken to measure the effect of vitamin K in the body as well as having their blood pressure tested while standing up and how well their legs are functioning. They are also asked to provide information about their contact with the health service over the past year.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
1. NHS Tayside (UK)
2. NHS Grampian (UK)
3. NHS Fife (UK)

When is the study starting and how long is it expected to run for?
September 2015 to September 2018

Who is funding the study?
Chief Scientist Office (UK)

Who is the main contact?
Dr Miles Witham

Contact information

Dr Miles Witham
Public

NIHR Newcastle Biomedical Research Centre
Biomedical Research Building
Campus for Ageing and Vitality
Newcastle
NE4 5PL
United Kingdom

Phone +44 (0)191 208 1317
Email Miles.Witham@newcastle.ac.uk

Study information

Study designMulti-centre randomised placebo-controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Community
Study typePrevention
Participant information sheet Not available in web format; please use contact details below to request a participant information sheet
Scientific titleVitamin K therapy to reduce falls – a pilot randomised controlled trial
Study acronymK-SWAY
Study hypothesisMain objective:
To test which dose of oral vitamin K2 (200 mcg or 400 mcg once daily for 1 year) most improves anteroposterior sway compared to placebo.

Secondary objectives:
1. To test whether 1 year of vitamin K2 supplementation (200 mcg or 400 mcg per day) improves markers of balance, lower limb function and postural blood pressure
2. To test whether 1 year of vitamin K2 supplementation (200 mcg or 400 mcg per day) reduces falls
3. To assess whether use of oral K2 supplementation (200 mcg or 400 mcg per day) is associated with a reduction in health and social care utilisation
Ethics approval(s)East of Scotland Research Ethics Committee, 15/12/2015, approval number: 15/ES/0197
ConditionPrevention of falls and loss of balance in older people
InterventionParticipants are randomly allocated into one of three groups:
Group 1: Receive a daily oral dosing of 400 mcg vitamin K2 (MK7 subtype) for a period of 12 months
Group 2: Receive a daily oral 200 mcg vitamin K2 (MK7 subtype) for a period of 12 months
Group 3: Receive a daily oral dose of a placebo for a period of 12 months
Intervention typeSupplement
Primary outcome measureDifference in anterior-posterior sway measured using a balance platform at baseline and 12 months.
Secondary outcome measures1. Additional markers of postural sway (mediolateral sway, 95% ellipse, RMS, total path length) measured using the AMTI sway meter at baseline, 6 and 12 months
2. Berg balance scale compared between groups at baseline, 6 and 12 months
3. Postural blood pressure drop on standing measured at baseline, 1 and 3 minutes after standing at 6 and 12 months
4. Vitamin K levels are determined by measuring dp-ucMGP levels in the blood at baseline and 12 months
5. Physical function determined with a short physical performance battery, timed up and go test at each time point at baseline, 6 and 12 months
6. Falls frequency determined from monthly falls diary to prospectively record falls
7. Health and social care utilisation data collected using a healthcare data and patient questionnaire at baseline, 6 and 12 months
Overall study start date01/09/2015
Overall study end date30/09/2018

Eligibility

Participant type(s)Patient
Age groupSenior
SexBoth
Target number of participants96
Total final enrolment95
Participant inclusion criteria1. Aged 65 years or over
2. Two or more self-reported falls in the previous 12 months OR at least one fall resulting in hospitalisation in the previous 12 months
3. Able (in the Investigators opinion) and willing to comply with all study requirements.
Participant exclusion criteria1. Unable to give written informed consent
2. Unable to stand without human assistance
3. Atrial fibrillation (as this group should usually be taking warfarin)
4. Taking warfarin (which antagonises vitamin K) or other coumadin derivatives
5. Taking vitamin K supplements
6. Known contraindication to Vitamin K
7. Currently enrolled in another trial (other than observational trials and registries), or within 30 days of completing another trial
8. Currently undertaking physiotherapy or another time-limited supervised non-pharmacological intervention to reduce falls risk
9. Intolerance to soya products
Recruitment start date01/04/2016
Recruitment end date31/01/2017

Locations

Countries of recruitment

  • Scotland
  • United Kingdom

Study participating centres

NHS Tayside
Ninewells Hospital
Dundee
DD1 9SY
United Kingdom
NHS Grampian
Aberdeen Royal Infirmary
Aberdeen
AB25 2ZN
United Kingdom
NHS Fife
Victoria Hospital
Kirkcaldy
KY2 5AH
United Kingdom

Sponsor information

Tayside Academic Science Centre (UK)
University/education

TASC Research & Development Office
Ninewells Hospital & Medical School
Residency Block, Level 3
George Pirie Way
Dundee
DD1 9SY
Scotland
United Kingdom

Phone +44 (0)1382 383900
Email c.forde@dundee.ac.uk
ROR logo "ROR" https://ror.org/049x86d03

Funders

Funder type

Government

Chief Scientist Office
Government organisation / Local government
Alternative name(s)
CSO
Location
United Kingdom

Results and Publications

Intention to publish date01/09/2019
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planMain trial results will be published within 12 months of end of trial, via report to funder (CSO, Scottish Government) and in peer-reviewed journal. Results will also be disseminated to participants and their families via a brief written summary and via presentation at study tea-parties.
IPD sharing planParticipant level, anonymised data will be available for sharing with bona-fide academic groups, subject to submission and approval of an analysis plan by a data access committee led by the Sponsor. Please contact Professor Witham or the Sponsor (TASCgovernance@dundee.ac.uk) to discuss proposals for data sharing.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 14/01/2018 14/01/2019 No No
Results article Results of study within a trial (SWAT) comparing two participant information sheets 01/12/2018 08/10/2019 Yes No
Results article 18/06/2019 20/08/2021 Yes No
HRA research summary 28/06/2023 No No

Additional files

ISRCTN18436190_BasicResults_14Jan2018.pdf
Uploaded 14/01/2019

Editorial Notes

20/08/2021: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
17/03/2020: Internal review.
08/10/2019: Publication reference added.
14/01/2018: The following changes were made to the trial record:
1. Contact details updated.
2. IPD sharing statement added.
3. The basic results of this trial have been uploaded as an additional file.
05/04/2016: Ethics approval information added.