Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 60, Issue 2, Pages 256-264Publisher
WILEY
DOI: 10.1111/j.1532-5415.2011.03830.x
Keywords
frailty; mortality; vitamin D
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Funding
- Intramural NIH HHS Funding Source: Medline
- NHLBI NIH HHS [R01 HL094507] Funding Source: Medline
- NIA NIH HHS [T32 AG000262, K25 AG034216-01A2, R01 AG027012, K23 AG027746, T32 AG00262, K23 AG027746-01A2, K25 AG034216, K23AG027746] Funding Source: Medline
- NICHD NIH HHS [K12 HD043489-01, K12 HD055931, R21 HD057274, R21HD057274, K12HD04389, R21 HD057274-01A1, K12 HD043489, K12HD055931] Funding Source: Medline
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OBJECTIVES: To assess whether serum 25-hydroxyvitamin D (25(OH)D) concentrations relate to transitions between the states of robustness, prefrailty, and frailty and to mortality in older adults. DESIGN: The Invecchiare in Chianti (InCHIANTI) Study, a prospective cohort study. SETTING: Tuscany, Italy. PARTICIPANTS: Adults aged 65 and older (N = 1,155). MEASUREMENTS: Serum 25(OH)D concentrations measured at baseline; frailty state (robust, prefrail, frail) assessed at baseline and 3 and 6 years after enrollment; and vital status determined 3 and 6 years after enrollment. RESULTS: The median (interquartile range) 25(OH)D concentration was 16.0 ng/mL (10.4-25.6 ng/mL; multiply by 2.496 to convert to nmol/L). Prefrail participants with 25(OH) D levels less than 20 ng/mL were 8.9% (95% confidence interval (CI) = 2.5-15.2%) more likely to die, 3.0% (95% CI = -5.6-14.6%) more likely to become frail, and 7.7% (95% CI = -3.5-18.7%) less likely to become robust than prefrail participants with 25(OH) D levels of 20 ng/mL or more. In prefrail participants, each 5-ng/mL decrement of continuous 25(OH)D was associated with 1.46 times higher odds of dying (95% CI = 1.18 -2.07) and 1.13 higher odds of incident frailty (95% CI = 0.90-1.39) than with recovery of robustness. Transi-tions from robustness or frailty were not associated with 25(OH)D levels. CONCLUSION: Results provide evidence that prefrailty is an at risk state from which older adults with high 25 (OH)D levels are more likely to recover than to decline, but high 25(OH)D levels were not associated with recovery from frailty. Thus, 25(OH)D levels should be investigated as a potential therapy to treat prefrailty and prevent further decline. J Am Geriatr Soc 60: 256-264, 2012.
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