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Is the 25-hydroxy-vitamin D serum concentration a good marker of frailty?

  • Published:
The journal of nutrition, health & aging

Abstract

Introduction

The phenotype proposed by Fried and colleagues is a widely used operational definition of frailty defining such state of extreme vulnerability of older persons. Low serum 25-hydroxy-vitamin D (25(OH)D) has been suggested as biomarker of frailty in literature.

Study design

Cross-sectional.

Objectives

To explore the association of 25(OH)D concentrations with the frailty phenotype and its criteria.

Methods

321 subjects referred by their general practitioner to a geriatric frailty clinic were assessed between January 1, 2013 and September 23, 2013. Adjusted logistic regression models were performed between serum concentrations of 25(OH)D and the frailty phenotype (global score as well as its specific criteria). Receivers operating curves were established in order to explore the existence of a possible threshold of vitamin D levels highly predictive of frailty.

Results

Two hundred forty-one (75%) participants had 25(OH)D levels lower than 22 ng/ml. No significant association was reported between 25(OH)D levels and frailty. Among the five criteria of frailty, 25(OH)D was only associated with sedentariness (odds ratio 0.97 [95% confidence interval 0.95-0.99]).

Conclusion

In our sample, no association was found between 25(OH)D levels and phenotype of frailty or the different frailty criterion except for sedentariness.

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References

  1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146–56.

    Article  CAS  PubMed  Google Scholar 

  2. Bandeen-Roche K, Xue Q-L, Ferrucci L, Walston J, Guralnik JM, Chaves P, et al. Phenotype of frailty: characterization in the women’s health and aging studies. J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):262–6.

    Article  PubMed  Google Scholar 

  3. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, et al. Effect of Vitamin D on falls: a meta-analysis. JAMA. 2004 Apr 28;291(16):1999–2006.

    Article  CAS  PubMed  Google Scholar 

  4. Abellan van Kan G, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B. The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008 Jan;12(1):29–37.

    Article  CAS  PubMed  Google Scholar 

  5. Visser M, Deeg DJH, Puts MTE, Seidell JC, Lips P. Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission. Am J Clin Nutr. 2006 Sep;84(3):616–22; quiz 671–2.

    CAS  PubMed  Google Scholar 

  6. Dupuy C, Lauwers-Cances V, van Kan GA, Gillette S, Schott A-M, Beauchet O, et al. Dietary vitamin D intake and muscle mass in older women. Results from a crosssectional analysis of the EPIDOS study. J Nutr Health Aging. 2013 Feb;17(2):119–24.

    Article  CAS  Google Scholar 

  7. Vernay M, Sponga M, Salanave B, Oleko A, Deschamps V, Malon A, et al. Statut en vitamine D de la population adulte en France: l’Etude nationale nutrition santé (ENNS, 2006-2007). Bulletin Epidémiologique Hebdomadaire

  8. Visser M, Deeg DJH, Lips P, Longitudinal Aging Study Amsterdam. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab. 2003 Dec;88(12):5766–72.

    Article  CAS  PubMed  Google Scholar 

  9. Morley JE, Baumgartner RN, Roubenoff R, Mayer J, Nair KS. Sarcopenia. J Lab Clin Med. 2001 Apr;137(4):231–43.

    Article  CAS  PubMed  Google Scholar 

  10. Muir SW, Montero-Odasso M. Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2011 Dec;59(12):2291–300.

    Article  PubMed  Google Scholar 

  11. Snijder MB, van Schoor NM, Pluijm SMF, van Dam RM, Visser M, Lips P. Vitamin D status in relation to one-year risk of recurrent falling in older men and women. J Clin Endocrinol Metab. 2006 Aug;91(8):2980–5.

    Article  CAS  PubMed  Google Scholar 

  12. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001 Aug;22(4):477–501.

    Article  CAS  PubMed  Google Scholar 

  13. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005 May 11;293(18):2257–64.

    Article  CAS  PubMed  Google Scholar 

  14. Mascarenhas R, Mobarhan S. Hypovitaminosis D-induced pain. Nutr Rev. 2004 Sep;62(9):354–9.

    Article  PubMed  Google Scholar 

  15. Houston DK, Cesari M, Ferrucci L, Cherubini A, Maggio D, Bartali B, et al. Association between vitamin D status and physical performance: the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2007 Apr;62(4):440–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Boxer RS, Dauser DA, Walsh SJ, Hager WD, Kenny AM. The association between vitamin D and inflammation with the 6-minute walk and frailty in patients with heart failure. J Am Geriatr Soc. 2008 Mar;56(3):454–61.

    Article  PubMed  Google Scholar 

  17. Gallagher JC. The effects of calcitriol on falls and fractures and physical performance tests. J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):497–501.

    Article  CAS  PubMed  Google Scholar 

  18. Puts MTE, Visser M, Twisk JWR, Deeg DJH, Lips P. Endocrine and inflammatory markers as predictors of frailty. Clin Endocrinol (Oxf). 2005 Oct;63(4):403–11.

    Article  CAS  PubMed  Google Scholar 

  19. Shardell M, Hicks GE, Miller RR, Kritchevsky S, Andersen D, Bandinelli S, et al. Association of low vitamin D levels with the frailty syndrome in men and women. J Gerontol A Biol Sci Med Sci. 2009 Jan;64(1):69–75.

    Article  PubMed  Google Scholar 

  20. Ensrud KE, Blackwell TL, Cauley JA, Cummings SR, Barrett-Connor E, Dam T-TL, et al. Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study. J Am Geriatr Soc. 2011 Jan;59(1):101–6.

    Article  PubMed  Google Scholar 

  21. Chang C-I, Chan D-CD, Kuo K-N, Hsiung CA, Chen C-Y. Vitamin D insufficiency and frailty syndrome in older adults living in a Northern Taiwan community. Arch Gerontol Geriatr. 2010 Feb;50 Suppl 1:S17–21.

    Article  CAS  PubMed  Google Scholar 

  22. Hirani V, Naganathan V, Cumming RG, Blyth F, Le Couteur DG, Handelsman DJ, et al. Associations between frailty and serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in older Australian men: the Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci. 2013 Sep;68(9):1112–21.

    Article  CAS  PubMed  Google Scholar 

  23. Tajar A, Lee DM, Pye SR, O’Connell MDL, Ravindrarajah R, Gielen E, et al. The association of frailty with serum 25-hydroxyvitamin D and parathyroid hormone levels in older European men. Age Ageing. 2013 May;42(3):352–9.

    Article  PubMed  Google Scholar 

  24. Wang Y, Wang Y-J, Zhan J-K, Tang Z-Y, Huang W, Tan P, et al. Vitamin D Binding Protein Affects the Correlation of 25(OH)D and Frailty in the Older Men. Int J Endocrinol. 2014;2014:543783.

    PubMed  PubMed Central  Google Scholar 

  25. Vellas B, Balardy L, Gillette-Guyonnet S, Abellan Van Kan G, Ghisolfi-Marque A, Subra J, et al. Looking for frailty in community-dwelling older persons: the Gérontopôle Frailty Screening Tool (GFST). J Nutr Health Aging. 2013 Jul;17(7):629–31.

    Article  CAS  PubMed  Google Scholar 

  26. Lewinsohn PM, Seeley JR, Roberts RE, Allen NB. Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychol Aging. 1997 Jun;12(2):277–87.

    Article  CAS  PubMed  Google Scholar 

  27. Cesari M, Pahor M, Lauretani F, Zamboni V, Bandinelli S, Bernabei R, et al. Skeletal muscle and mortality results from the InCHIANTI Study. J Gerontol A Biol Sci Med Sci. 2009 Mar;64(3):377–84.

    Article  PubMed  Google Scholar 

  28. Patel KV, Coppin AK, Manini TM, Lauretani F, Bandinelli S, Ferrucci L, et al. Midlife physical activity and mobility in older age: The InCHIANTI study. Am J Prev Med. 2006 Sep;31(3):217–24.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ersfeld DL, Rao DS, Body J-J, Sackrison JL, Miller AB, Parikh N, et al. Analytical and clinical validation of the 25 OH vitamin D assay for the LIAISON automated analyzer. Clin Biochem. 2004 Oct;37(10):867–74.

    Article  CAS  PubMed  Google Scholar 

  30. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.

    Article  CAS  PubMed  Google Scholar 

  31. Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982 Apr;143(1):29–36.

    Article  CAS  PubMed  Google Scholar 

  32. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988 Sep;44(3):837–45.

    Article  CAS  PubMed  Google Scholar 

  33. Wong YYE, McCaul KA, Yeap BB, Hankey GJ, Flicker L. Low vitamin D status is an independent predictor of increased frailty and all-cause mortality in older men: the Health in Men Study. J Clin Endocrinol Metab. 2013 Sep;98(9):3821–8.

    Article  CAS  PubMed  Google Scholar 

  34. Wilhelm-Leen ER, Hall YN, Deboer IH, Chertow GM. Vitamin D deficiency and frailty in older Americans. J Intern Med. 2010 Aug;268(2):171–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Ensrud KE, Ewing SK, Fredman L, Hochberg MC, Cauley JA, Hillier TA, et al. Circulating 25-hydroxyvitamin D levels and frailty status in older women. J Clin Endocrinol Metab. 2010 Dec;95(12):5266–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Shardell M, D’Adamo C, Alley DE, Miller RR, Hicks GE, Milaneschi Y, et al. Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: the Invecchiare in Chianti Study. J Am Geriatr Soc. 2012 Feb;60(2):256–64.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Gerdhem P, Ringsberg KAM, Obrant KJ, Akesson K. Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. Osteoporos Int. 2005 Nov;16(11):1425–31.

    Article  CAS  PubMed  Google Scholar 

  38. Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266–81.

    Article  CAS  PubMed  Google Scholar 

  39. Pramyothin P, Techasurungkul S, Lin J, Wang H, Shah A, Ross PD, et al. Vitamin D status and falls, frailty, and fractures among postmenopausal Japanese women living in Hawaii. Osteoporos Int. 2009 Nov;20(11):1955–62.

    Article  CAS  PubMed  Google Scholar 

  40. Toffanello ED, Perissinotto E, Sergi G, Zambon S, Musacchio E, Maggi S, et al. Vitamin D and physical performance in elderly subjects: the Pro.V.A study. PLoS ONE. 2012;7(4):e34950.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Tice JA. Vitamin D for the Prevention of Osteoporotic Fractures. In san fransisco: California Technology Assessment Forum; 2011.

    Google Scholar 

  42. Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated metaanalysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2011 Dec 20;155(12):827–38.

    PubMed  Google Scholar 

  43. Stockton KA, Mengersen K, Paratz JD, Kandiah D, Bennell KL. Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis. Osteoporos Int. 2011 Mar;22(3):859–71.

    CAS  PubMed  Google Scholar 

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Correspondence to Thomas Krams.

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Krams, T., Cesari, M., Guyonnet, S. et al. Is the 25-hydroxy-vitamin D serum concentration a good marker of frailty?. J Nutr Health Aging 20, 1034–1039 (2016). https://doi.org/10.1007/s12603-016-0714-1

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  • DOI: https://doi.org/10.1007/s12603-016-0714-1

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