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

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

Research output: Contribution to journalArticlepeer-review

140 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)5266-5273
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number12
DOIs
StatePublished - Dec 2010

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