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Clinical Trial
. 2025 Feb 22;37(1):43.
doi: 10.1007/s40520-025-02938-4.

Falls and physical function in older patients with Benign Paroxysmal Positional Vertigo (BPPV): findings from a placebo controlled, double blinded randomized control trial (RCT) investigating efficacy of vitamin D treatment in lowering the recurrence rate of BPPV

Xiaoting Huang  1 , Kenneth Wei De Chua  2 , Shirlene Pei Shi Moh  3 , Heng Wai Yuen  2 , David Yong Ming Low  2 , Poongkulali Anaikatti  4 , Arshad Iqbal  4 , Barbara Helen Rosario  5
Affiliations
Clinical Trial

Falls and physical function in older patients with Benign Paroxysmal Positional Vertigo (BPPV): findings from a placebo controlled, double blinded randomized control trial (RCT) investigating efficacy of vitamin D treatment in lowering the recurrence rate of BPPV

Xiaoting Huang et al. Aging Clin Exp Res. .

Abstract

Background: 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.

Aims: 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.

Methods: 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.

Results: 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.

Discussion: 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.

Conclusion: Vitamin D replacement was associated with fewer BPPV recurrences and improved function assessed with 5x chair stand test.

Keywords: BPPV; Falls; Fear of falling; Older adults; Vitamin D.

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Conflict of interest statement

Declarations. Ethical approval: Ethics approval was overseen by the Centralised Institutional Review Board (ethics review number 2020/2654) and regulatory approval from Health Sciences Authority (certificate number CTC2100006) prior to enrolment of patients into the study. The trial was registered under Medicines on 2020-10-09 (Clinical Trials -Trial Registration Number NCT04578470). All enrolled patients provided written informed consent for their participation and all methods included in this study are in accordance with ethical principles that have their origin in the Declaration of Helsinki. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT diagram
See this image and copyright information in PMC

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