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Pabst, G. ; Zimmermann, A.-K. ; Huth, C. ; Koenig, W.* ; Ludwig, T. ; Zierer, A. ; Peters, A. ; Thorand, B.

Association of low 25-hydroxyvitamin D levels with the frailty syndrome in an aged population: Results from the KORA-Age Augsburg study.

J. Nutr. Health Aging 19, 258-264 (2015)

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Conclusion: Subjects with 25(OH)D serum levels ≥15 ng/ml were less frequently prefrail or frail. Objectives: Older adults often suffer from vitamin D deficiency and from the frailty syndrome charac-terized by different physical limitations, complicating independent everyday life. Previous studies have suggested a relationship between vitamin D status and the frailty syndrome, but results have been partly inconsistent, particularly regarding the shape of the association. Therefore, our aim was to further assess the association of 25-hydroxyvitamin D (25(OH)D) serum levels and frailty in older participants. Design: Cross-sectional population-based study. Participants: The study population included 478 men and 462 women of the KORA (COoperative health research in the Region of Augsburg)-Age study born before 1944 examined in 2009. Measurements: Classification of participants into different frailty states was performed according to the following criteria: weight loss, exhaustion, physical inactivity, slowness, and weakness. Participants who met 1−2 or ≥3 of the 5 criteria were classified as prefrail or frail, respectively. Total 25(OH)D was measured in non-fasting serum samples with an enhanced chemiluminescence immunoassay. Sequential logistic regression models adjusted for age, sex, season, lifestyle factors, diseases and biomarkers including parathyroid hormone (PTH) were calculated. Results: High levels of 25(OH)D were inversely associated with being prefrail (N=351) or frail (N=38) in the model adjusted for age, sex, season and lifestyle factors. Compared to levels <15 ng/ml, odds ratios (ORs) (95% confidence intervals (CIs) were 0.52 (0.34–0.78) for levels of 15−<20 ng/ml, 0.55 (0.37–0.81) for levels of 20−<30 ng/ml and 0.32 (0.21–0.51) for levels ≥30 ng/ml. Additional adjustment for potential mediators including PTH only slightly attenuated these associations. For single frailty-components, significantly decreased ORs were found for exhaustion, physical inactivity and slowness comparing 25(OH)D levels ≥30 ng/ml with levels <15 ng/ml.

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