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. 2010 Dec;95(12):5266-73.
doi: 10.1210/jc.2010-2317.

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

Kristine E Ensrud  1 , 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
Affiliations

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

Kristine E Ensrud et al. J Clin Endocrinol Metab. 2010 Dec.

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.

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Figures

Figure 1
Figure 1
Cohort for cross-sectional and longitudinal analyses.
Figure 2
Figure 2
Restricted cubic spline plot of log odds ratios for greater frailty status at baseline by level of 25(OH)D.
See this image and copyright information in PMC

Comment in

  • Frailty: a D-ficiency syndrome of aging?
    Rosen CJ, Manson JE. Rosen CJ, et al. J Clin Endocrinol Metab. 2010 Dec;95(12):5210-2. doi: 10.1210/jc.2010-2544. J Clin Endocrinol Metab. 2010. PMID: 21131543 No abstract available.

References

    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA 2001 Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156 - PubMed
    1. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, Tracy JK, Hochberg MC, Rodondi N, Cawthon PM 2007 Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 62:744–751 - PubMed
    1. Cawthon PM, Marshall LM, Michael Y, Dam TT, Ensrud KE, Barrett-Connor E, Orwoll ES 2007 Frailty in older men: prevalence, progression, and relationship with mortality. J Am Geriatr Soc 55:1216–1223 - PubMed
    1. Rockwood K, Howlett SE, MacKnight C, Beattie BL, Bergman H, Hebert R, Hogan DB, Wolfson C, McDowell I 2004 Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci 59:1310–1317 - PubMed
    1. Effectiveness and safety of vitamin D in relation to bone health. Agency for Healthcare Research and Quality 2007. http://www.ahrq.gov/clinic/tp/vitadtp.htm. (Accessed April 19, 2010)

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