Circulating 25-hydroxyvitamin D levels and frailty status in older women.

Abstract

CONTEXT:

Vitamin D deficiency and frailty are common with aging, but the association between these conditions is uncertain.

OBJECTIVE:

To determine the association between 25-hydroxyvitamin D (25(OH)D) levels and prevalent and incident frailty status among older women.

DESIGN:

Cross-sectional and longitudinal analyses of a prospective cohort study.

SETTING:

Four U.S. centers.

PARTICIPANTS:

6307 women aged≥69 years.

MAIN OUTCOME MEASURES:

Frailty status classified as robust, intermediate stage, or frail at baseline; and robust, intermediate stage, frail, or dead (all-cause mortality) at follow-up an average of 4.5 years later.

RESULTS:

At baseline, there was a U-shaped association between 25(OH)D level and odds of frailty with the lowest risk among women with levels 20.0-29.9 ng/ml (referent group). Compared with this group, the odds of frailty were higher among those with levels<15.0 ng/ml [multivariable odds ratio (MOR) 1.47, 95% confidence interval (CI), 1.19-1.82], those with levels 15.0-19.9 ng/ml (MOR 1.24, 95% CI 0.99-1.54), and those with levels≥30 ng/ml (MOR 1.32, 95% CI 1.06-1.63). Among 4551 nonfrail women at baseline, the odds of frailty/death (vs. robust/intermediate) at follow-up appeared higher among those with levels 15.0-19.9 ng/ml (MOR 1.21, 95% CI 0.99-1.49), but the CI overlapped 1.0. The odds of death (vs. robust/intermediate/frail at follow-up) was higher among those with levels<15.0 ng/ml (MOR 1.40, 95% CI 1.04-1.88) and those with levels 15.0-19.9 ng/ml (MOR 1.30, 95% CI 0.97-1.75), although the latter association did not quite reach significance.

CONCLUSION:

Lower (<20 ng/ml) and higher (≥30 ng/ml) levels of 25(OH)D among older women were moderately associated with a higher odds of frailty at baseline. Among nonfrail women at baseline, lower levels (<20 ng/ml) were modestly associated with an increased risk of incident frailty or death at follow-up.

• Authors: Kristine E Ensrud, Susan K Ewing, Lisa Fredman, Marc C Hochberg, Jane A Cauley, Teresa A Hillier, Steven R Cummings, Kristine Yaffe, Peggy M Cawthon, Study of Osteoporotic Fractures Research Group
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 95 Issue 12 Pg. 5266-73 (Dec 2010) ISSN: 1945-7197 [Electronic] United States
• PMID: 21131545 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Calcium, Dietary
• Ergocalciferols
• Vitamin D
• Cholecalciferol
• 25-hydroxyvitamin D

Topics

• Aged
• Alcohol Drinking
• Calcium, Dietary
• Cholecalciferol (blood)
• Cross-Sectional Studies
• Ergocalciferols (blood)
• Female
• Follow-Up Studies
• Frail Elderly (statistics & numerical data)
• Health Status
• Humans
• Longitudinal Studies
• Odds Ratio
• Prevalence
• Risk Assessment
• Smoking (epidemiology)
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (complications)