Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: The invecchiare in Chianti study

Michelle Shardell, Christopher D'Adamo, Dawn E. Alley, Ram R. Miller, Gregory E. Hicks, Yuri Milaneschi, Richard D. Semba, Antonio Cherubini, Stefania Bandinelli, Luigi Ferrucci

Research output: Contribution to journalArticlepeer-review

Abstract

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. Transitions 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.

Original languageEnglish
Pages (from-to)256-264
Number of pages9
JournalJournal of the American Geriatrics Society
Volume60
Issue number2
DOIs
Publication statusPublished - Feb 2012

Keywords

  • frailty
  • mortality
  • vitamin D

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Fingerprint Dive into the research topics of 'Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: The invecchiare in Chianti study'. Together they form a unique fingerprint.

Cite this