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Multicenter Study
. 2011 Jan;59(1):101-6.
doi: 10.1111/j.1532-5415.2010.03201.x. Epub 2010 Dec 16.

Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study

Kristine E Ensrud  1 , Terri L Blackwell, Jane A Cauley, Steven R Cummings, Elizabeth Barrett-Connor, Thuy-Tien L Dam, Andrew R Hoffman, James M Shikany, Nancy E Lane, Marcia L Stefanick, Eric S Orwoll, Peggy M Cawthon; Osteoporotic Fractures in Men Study Group
Affiliations
Multicenter Study

Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study

Kristine E Ensrud et al. J Am Geriatr Soc. 2011 Jan.

Abstract

Objectives: To determine the cross-sectional and longitudinal associations between 25-hydroxyvitamin D (25(OH)D) levels and frailty status in older men.

Design: Prospective cohort study.

Setting: Six U.S. community-based centers.

Participants: One thousand six hundred six men aged 65 and older.

Measurements: 25(OH)D (liquid chromatography tandem mass spectroscopy) and frailty status (criteria similar to those used in the Cardiovascular Health Study) measured at baseline; frailty status assessment repeated an average of 4.6 years later. Frailty status was classified as robust, intermediate, or frail at baseline and robust, intermediate, frail, or dead at follow-up.

Results: After adjusting for multiple potential confounders, men with 25(OH)D levels less than 20.0 ng/mL had 1.5 times higher odds (multivariate odds ratio (MOR)=1.47, 95% confidence interval (CI)=1.07-2.02) of greater frailty status at baseline than men with 25(OH)D levels of 30.0 ng/mL or greater (referent group), whereas frailty status was similar in men with 25(OH)D levels from 20.0 to 29.9 ng/mL and those with levels of 30.0 ng/mL or greater (MOR=1.02, 95% CI=0.78-1.32). However, in 1,267 men not classified as frail at baseline, there was no association between lower baseline 25(OH)D level and odds of greater frailty status at the 4.6-year follow-up. Findings were the same when 25(OH)D was expressed in quartiles or as a continuous variable.

Conclusion: Lower levels of 25(OH)D (<20.0 ng/mL) in community-dwelling older men were independently associated with greater evidence of frailty at baseline but did not predict greater risk of greater frailty status at 4.6 years.

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Figures

Figure 1
Figure 1
Restricted Cubic Spline Plot of Odd Ratios for Greater Frailty Status at Baseline by Level of 25(OH)D
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