Abstract
Objectives
To examine the potential association between serum 25(OH) vitamin D and the performance on the Short Physical Performance Battery (SPPB) including the sub-components; five repeated chair stands test, 4 meters walk test and balance in older mobility-limited community-dwelling men and women.
Design
A cross sectional study was performed in American and Swedish subjects who were examined for potential participation in a combined exercise and nutrition intervention trial. Logistic regression analysis and linear regression analyses were performed to evaluate the association for 25(OH)D with the overall score on the SBBP, chair stand, gait speed and balance.
Participants
Community-dwelling (mean age 77.6 ± 5.3 years) mobility limited American (n=494) and Swedish (n=116) females (59%) and males.
Measurements
The SPPB (0-12 points) includes chair stand (s), gait speed (m/s) and a balance test. Mobility limitation i.e., SPPB score ≤ 9 was an inclusion criterion. A blood sample was obtained to measure serum 25(OH)vitamin D concentrations.
Results
No clear association of 25(OH)D with SPPB scores was detected either when 25(OH)D was assessed as a continuous variable or when categorized according to serum concentrations of <50, 50-75 or <75 nmol/L. However, when analyzing the relationship between 25(OH)D and seconds to perform the chair stands, a significant quadratic relationship was observed. Thus, at serum levels of 25(OH)D above 74 nmol/L, higher concentrations appeared to be advantageous for the chair stand test, whereas for serum levels below 74 nmol/L this association was not observed.
Conclusion
This cross- sectional study lacked clear association between serum 25(OH)D and physical performance in mobility limited adults. A potentially interesting observation was that at higher serum levels of 25(OH)D a better performance on the chair stand test was indicated.
Similar content being viewed by others
References
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;293:2257–2264. doi: 10.1001/jama.293.18.2257
Bischoff-Ferrari H, Willett W, Orav E, Lips P, Meunier P, Lyons R, Flicker L, Wark J, Jackson R, Cauley J, Meyer H, Pfeifer M, Sanders K, Stahelin H, Theiler R, Dawson-Hughes B. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 2012;367:40–49.
Williams JA, Sink KM, Tooze JA, Atkinson HH, Cauley JA, Yaffe K, Tylavsky FA, Rubin SM, Simonsick EM, Kritchevsky SB, Houston DK. Low 25-hydroxyvitamin D concentrations predict incident depression in well-functioning older adults: the health, aging, and body composition study. J Gerontol A Biol Sci Med Sci 2015;70:757–763. doi: 10.1093/gerona/glu184
Dobnig H, Pilz S, Scharnagl H, et al. INdependent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin d levels with all-cause and cardiovascular mortality. Arch Intern Med 2008;168:1340–1349. doi: 10.1001/ archinte.168.12.1340
Melamed ML, Michos ED, Post W, Astor B. 25-hydroxyvitamin d levels and the risk of mortality in the general population. Arch Intern Med 2008;168:1629–1637. doi: 10.1001/archinte.168.15.1629
Stewart R, Hirani V. Relationship between vitamin D levels and depressive symptoms in older residents from a national survey population. Psychosom Med 2010;72:608–612. doi: 10.1097/PSY.0b013e3181e9bf15
Visser M, Deeg DJ, Lips P. 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;88:5766–5772.
Morley JE, Argiles JM, Evans WJ, Bhasin S, Cella D, Deutz NE, Doehner W, Fearon KC, Ferrucci L, Hellerstein MK, Kalantar-Zadeh K, Lochs H, Mac Donald N, Mulligan K, Muscaritoli M, Ponikowski P, Posthauer ME, Rossi Fanelli F, Schambelan M, Schols AM, Schuster MW, Anker SD. Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc 2010;11:391–396. doi: 10.1016/j.jamda.2010.04.014
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412–423. doi: 10.1093/ageing/afq034
Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, Abellan van Kan G, Andrieu S, Bauer J, Breuille D, Cederholm T, Chandler J, De Meynard C, Donini L, Harris T, Kannt A, Keime Guibert F, Onder G, Papanicolaou D, Rolland Y, Rooks D, Sieber C, Souhami E, Verlaan S, Zamboni M. Sarcopenia: An Undiagnosed Condition in Older Adults. Current Consensus Definition: Prevalence, Etiology, and Consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc 2011;12:249–256. doi: 10.1016/j.jamda.2011.01.003
Beaudart C, Reginster JY, Petermans J, Gillain S, Quabron A, Locquet M, Slomian J, Buckinx F, Bruyère O. Quality of life and physical components linked to sarcopenia: The SarcoPhAge study. Exp Gerontol 2015;69:103–110. doi: 10.1016/j.exger.2015.05.003
Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E, Bernabei R, Onder G. Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr 2012;31:652–658. doi: 10.1016/j.clnu.2012.02.007
Stoever K, Heber A, Eichberg S, Zijlstra W, Brixius K. Changes of Body Composition, Muscular Strength and Physical Performance Due to Resistance Training in Older Persons with Sarcopenic Obesity. J Frailty Aging 2015;4:216–222.
Cruz-Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, Boirie Y, Chen L-K, Fielding RA, Martin FC, Michel J-P, Sieber C, Stout JR, Studenski SA, Vellas B, Woo J, Zamboni M, Cederholm T. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 2014;43:748–759. doi: 10.1093/ageing/afu115
International Working Group on S. Sarcopenia: An Undiagnosed Condition in Older Adults. Current Consensus Definition: Prevalence, Etiology, and Consequences. J Am Med Dir Assoc 2011;12:249–256. doi: 10.1016/j.jamda.2011.01.003
Rabassa M, Zamora-Ros R, Andres-Lacueva C, Urpi-Sarda M, Bandinelli S, Ferrucci L, Cherubini A. Association between Both Total Baseline Urinary and Dietary Polyphenols and Substantial Physical Performance Decline Risk in Older Adults: A 9-year Follow-up of the InCHIANTI Study. J Nutr Health Aging 2016;20:478–485.
Fougere B, Mazzuco S, Spagnolo P, Guyonnet S, Vellas B, Cesari M, Gallucci M. Association between the Mediterranean-style Dietary Pattern Score and Physical Performance: Results from TRELONG Study. J Nutr Health Aging 2016;20:415–419.
Cesari M, Incalzi RA, Zamboni V, Pahor M. Vitamin D hormone: a multitude of actions potentially influencing the physical function decline in older persons. Geriatr Gerontol Int 2011;11:133–142. doi: 10.1111/j.1447-0594.2010.00668.x
Wicherts I, van Schoor N, Boeke A, Visser M, Deeg D, Smit J, Knol D, Lips P. Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab 2007;92:2058–2065.
Toffanello ED, Perissinotto E, Sergi G, Zambon S, Musacchio E, Maggi S, Coin A, Sartori L, Corti MC, Baggio G, Crepaldi G, Manzato E. Vitamin D and physical performance in elderly subjects: the Pro.V.A study. PLoS One 2012;7:e34950. doi: 10.1371/journal.pone.0034950
Sohl E, de Jongh RT, Heijboer AC, Swart KM, Brouwer-Brolsma EM, Enneman AW, de Groot CP, van der Velde N, Dhonukshe-Rutten RA, Lips P, van Schoor NM. Vitamin D status is associated with physical performance: the results of three independent cohorts. Osteoporos Int 2013;24:187–196. doi: 10.1007/s00198-012-2124-5
Houston DK, Tooze JA, Davis CC, Chaves PH, Hirsch CH, Robbins JA, Arnold AM, Newman AB, Kritchevsky SB. Serum 25-hydroxyvitamin D and physical function in older adults: the Cardiovascular Health Study All Stars. J Am Geriatr Soc 2011;59:1793–1801. doi: 10.1111/j.1532-5415.2011.03601.x
Houston DK, Neiberg RH, Tooze JA, Hausman DB, Johnson MA, Cauley JA, Bauer DC, Shea MK, Schwartz GG, Williamson JD, Harris TB, Kritchevsky SB. Low 25-Hydroxyvitamin D Predicts the Onset of Mobility Limitation and Disability in Community-Dwelling Older Adults: The Health ABC Study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2012;doi: 10.1093/gerona/gls136
Sohl E, Jongh RTd, Heymans MW, Schoor NMv, Lips P. Thresholds for Serum 25(OH)D Concentrations With Respect to Different Outcomes. The Journal of Clinical Endocrinology & Metabolism 2015;100:2480–2488. doi: 10.1210/jc.2015-1353
Mathei C, Van Pottelbergh G, Vaes B, Adriaensen W, Gruson D, Degryse JM. No relation between vitamin D status and physical performance in the oldest old: results from the Belfrail study. Age Ageing 2013;42:186–190. doi: 10.1093/ageing/afs186
Kirn DR, Koochek A, Reid KF, von Berens A, Travison TG, Folta S, Sacheck J, Nelson M, Liu C, Phillips E, Aberg AC, Nydahl M, Gustafsson T, Cederholm T, Fielding RA. The Vitality, Independence, and Vigor in the Elderly 2 Study (VIVE2): Design and Methods. Contemp Clin Trials 2015;doi: 10.1016/j.cct.2015.06.001
Folstein MF, Folstein SE, McHugh PR. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB. Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2000;55:M221–M231.
Freiberger E, de Vreede P, Schoene D, Rydwik E, Mueller V, Frändin K, Hopman-Rock M. Performance-based physical function in older community-dwelling persons: a systematic review of instruments. Age Ageing 2012;41:712–721. doi: 10.1093/ageing/afs099
Puthoff ML. Outcome Measures in Cardiopulmonary Physical Therapy: Short Physical Performance Battery. Cardiopulm Phys Ther J 2008;19:17–22.
Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-Extremity Function in Persons over the Age of 70 Years as a Predictor of Subsequent Disability. N Engl J Med 1995;332:556–562. doi: 10.1056/NEJM199503023320902
Holick M, Binkley N, Bischoff-Ferrari H, Gordon C, Hanley D, Heaney R, Murad M, Weaver C, Society E. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911–1930.
Institute of Medicine FaNB. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press 2010
White H. A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity. Econometrica 1980;48:817–838. doi: 10.2307/1912934
Melhus H, Snellman G, Gedeborg R, Byberg L, Berglund L, Mallmin H, Hellman P, Blomhoff R, Hagstrom E, Arnlov J, Michaelsson K. Plasma 25-hydroxyvitamin D levels and fracture risk in a community-based cohort of elderly men in Sweden. J Clin Endocrinol Metab 2010;95:2637–2645. doi: 10.1210/jc.2009-2699
StataCorp. 2013. Stata Statistical Software: College Station, TX: StataCorp LP. Release 13. ed.
Dam TT, von Muhlen D, Barrett-Connor EL. Sex-specific association of serum vitamin D levels with physical function in older adults. Osteoporos Int 2009;20:751–760. doi: 10.1007/s00198-008-0749-1
Houston DK, Cesari M, Ferrucci L, Cherubini A, Maggio D, Bartali B, Johnson MA, Schwartz GG, Kritchevsky SB. Association Between Vitamin D Status and Physical Performance: The InCHIANTI Study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2007;62:440–446.
Cesari M, Onder G, Zamboni V, Manini T, Shorr RI, Russo A, Bernabei R, Pahor M, Landi F. Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE study. BMC Geriatr 2008;8:34. doi: 10.1186/1471-2318-8-34
Arnau A, Espaulella J, Méndez T, Serrarols M, Canudas J, Formiga F, Ferrer M. Lower limb function and 10-year survival in population aged 75 years and older. Fam Pract 2016;33:10–16. doi: 10.1093/fampra/cmv088
Ward RE, Leveille SG, Beauchamp MK, Travison T, Alexander N, Jette AM, Bean JF. Functional performance as a predictor of injurious falls in older adults. J Am Geriatr Soc 2015;63:315–320. doi: 10.1111/jgs.13203
Bischoff-Ferrari H, Dietrich T, Orav E, Hu F, Zhang Y, Karlson E, Dawson-Hughes B. Higher 25-hydroxyvitamin D concentrations are associated with better lowerextremity function in both active and inactive persons aged>or =60 y. Am J Clin Nutr 2004;80:752–758.
Tieland M, Brouwer-Brolsma EM, Nienaber-Rousseau C, van Loon LJ, De Groot LC. Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people. Eur J Clin Nutr 2013;67:1050–1055. doi: 10.1038/ejcn.2013.144
Lagari V, Gómez-Marín O, Levis S. The role of vitamin D in improving physical performance in the elderly. J Bone Miner Res 28:2194-2201. doi: 10.1002/jbmr.1949
Bischoff-Ferrari HA, Dawson-Hughes B, Orav E, et al. Monthly high-dose vitamin d treatment for the prevention of functional decline: A randomized clinical trial. JAMA Intern Med:2016;1–10. doi: 10.1001/jamainternmed.2015.7148
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know. J Clin Endocrinol Metab 2011;96:53–58. doi: 10.1210/jc.2010-2704
Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JPA. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ 2014;348 doi: 10.1136/bmj.g2035
Enko D, Fridrich L, Rezanka E, Stolba R, Ernst J, Wendler I, Fabian D, Hauptlorenz S, Halwachs-Baumann G. 25-hydroxy-Vitamin D status: limitations in comparison and clinical interpretation of serum-levels across different assay methods. Clin Lab 2014;60:1541–1550.
Snellman G, Melhus H, Gedeborg R, Byberg L, Berglund L, Wernroth L, Michaëlsson K. Determining Vitamin D Status: A Comparison between Commercially Available Assays. PLoS One 2010;5:e11555. doi: 10.1371/journal.pone.0011555
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
von Berens, Å., Cederholm, T., Fielding, R.A. et al. Physical Performance and Serum 25(OH)Vitamin D Status in Community Dwelling Old Mobility Limited Adults: A Cross-Sectional Study. J Nutr Health Aging 22, 1–7 (2018). https://doi.org/10.1007/s12603-016-0849-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-016-0849-0