TY - JOUR
T1 - Low vitamin d levels and frailty status in older adults
T2 - A systematic review and meta-analysis
AU - Marcos-Pérez, Diego
AU - Sánchez-Flores, María
AU - Proietti, Stefania
AU - Bonassi, Stefano
AU - Costa, Solange
AU - Teixeira, Joao Paulo
AU - Fernández-Tajes, Juan
AU - Pásaro, Eduardo
AU - Valdiglesias, Vanessa
AU - Laffon, Blanca
N1 - Funding Information:
Funding: This research was funded by Xunta de Galicia [ED431B 2019/02]; Ministerio de Educación, Cultura y Deporte [BEAGAL18/00142 to V.V, PRX19/00353 to B.L.]; and Deputación Provincial de A Coruña [to D.M.-P. and M.S.-F.] Acknowledgments: We want to express our gratitude to K. Ensrud (Center for Chronic Disease Outcomes Research, VA Medical Center); J. Sanchís (Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia); and S. Vogt (Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health) for sending us their data.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - Serum vitamin D deficiency is widespread among older adults and is a potential modifiable risk factor for frailty. Moreover, frailty has been suggested as an intermediate step in the association between low levels of vitamin D and mortality. Hence, we conducted a systematic review of the literature and meta-analysis to test the possible association of low concentrations of serum 25-hydroxyvitamin D (25(OH)D), a marker of vitamin D status, with frailty in later life. We reviewed cross-sectional or longitudinal studies evaluating populations of older adults and identifying frailty by a currently validated scale. Meta-analyses were restricted to cross-sectional data from studies using Fried’s phenotype to identify frailty. Twenty-six studies were considered in the qualitative synthesis, and thirteen studies were included in the meta-analyses. Quantitative analyses showed significant differences in the comparisons of frail (standardized mean difference (SMD)—1.31, 95% confidence interval (CI) (−2.47, −0.15), p = 0.0271) and pre-frail (SMD—0.79, 95% CI (−1.58, −0.003), p = 0.0491) subjects vs. non-frail subjects. Sensitivity analyses reduced heterogeneity, resulting in a smaller but still highly significant between-groups difference. Results obtained indicate that lower 25(OH)D levels are significantly associated with increasing frailty severity. Future challenges include interventional studies testing the possible benefits of vitamin D supplementation in older adults to prevent/palliate frailty and its associated outcomes.
AB - Serum vitamin D deficiency is widespread among older adults and is a potential modifiable risk factor for frailty. Moreover, frailty has been suggested as an intermediate step in the association between low levels of vitamin D and mortality. Hence, we conducted a systematic review of the literature and meta-analysis to test the possible association of low concentrations of serum 25-hydroxyvitamin D (25(OH)D), a marker of vitamin D status, with frailty in later life. We reviewed cross-sectional or longitudinal studies evaluating populations of older adults and identifying frailty by a currently validated scale. Meta-analyses were restricted to cross-sectional data from studies using Fried’s phenotype to identify frailty. Twenty-six studies were considered in the qualitative synthesis, and thirteen studies were included in the meta-analyses. Quantitative analyses showed significant differences in the comparisons of frail (standardized mean difference (SMD)—1.31, 95% confidence interval (CI) (−2.47, −0.15), p = 0.0271) and pre-frail (SMD—0.79, 95% CI (−1.58, −0.003), p = 0.0491) subjects vs. non-frail subjects. Sensitivity analyses reduced heterogeneity, resulting in a smaller but still highly significant between-groups difference. Results obtained indicate that lower 25(OH)D levels are significantly associated with increasing frailty severity. Future challenges include interventional studies testing the possible benefits of vitamin D supplementation in older adults to prevent/palliate frailty and its associated outcomes.
KW - Frailty
KW - Meta-analysis
KW - Older adults
KW - Systematic review
KW - Vitamin D
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U2 - 10.3390/nu12082286
DO - 10.3390/nu12082286
M3 - Review article
C2 - 32751730
AN - SCOPUS:85088941046
VL - 12
SP - 1
EP - 20
JO - Nutrients
JF - Nutrients
SN - 2072-6643
IS - 8
M1 - 2286
ER -