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Treatment to Enhance Balance, Reduce Fear of Falling in OAs

Denosumab can strengthen balance, increase function, and reduce the fear of falling among older adults who are at risk of fractures or falling, according to new research presented at the American Society for Bone and Mineral Research 2019 Annual Meeting.

These new results may explain the anti-fall efficacy that denosumab demonstrated in the FREEDOM trial. In that trial, participants who had received treatment with denosumab experienced a significant reduction in falls compared with participants who had received placebo. 

To assess the mechanisms behind the anti-fall effect, Ahmed Al Saedi, PhD, from the University of Melbourne, and colleagues evaluated the impact of denosumab treatment on muscle strength, function, and balance in 79 community-dwelling older adults who had a high risk of fractures or falling. 

The participants completed the following assessments: handgrip strength, gait speed, Short Physical Performance Battery (SPPB), timed up and go test, four square step test, and posturography. The researchers also measured the participants’ fear of falling with the Falls Efficacy Scale International (FES-I) and Activities-specific Balance Confidence scale.

Assessments were repeated at a 6-month follow-up after participants had received treatment with denosumab (n=51) or zoledronic acid (n=28).

At the 6-month follow-up, participants who had received treatment with denosumab improved their gait speed by 0.06 m/s. The time it took to complete the timed up and go and four square step tests also improved by 1.7 seconds each.

The participants who received treatment with denosumab were less fearful of falling, having had a 3.1-point decrease in FES-I. 

The researchers also observed a trend toward significant improvements in SPPB score of 1.1 points and limits of stability of 11.9 cm2.

“Further studies should be conducted in larger trials to clarify these effects and potential mechanisms,” the researchers concluded.

—Colleen Murphy

Reference:

Al Saedi A, Phu S, Hassan EB, Vogrin S, Kirk B, Duque G. Effect of denosumab on falls, muscle strength and function in community dwelling older adults [Abstract #LB-1170]. Presented at: American Society for Bone and Mineral Research 2019 Annual Meeting; September 23, 2019; Orlando, FL.

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