Low serum carotenoids and development of severe walking disability among older women living in the community: The Women's Health and Aging Study I

Objective: To determine whether low serum carotenoid levels, an indicator of low intake of fruits and vegetables, are associated with the progression of disability in older women. Design: Longitudinal analysis in a population-based cohort. Setting: Moderately-severely disabled women, ≥65 years, living in the community in Baltimore, Maryland (the Women's Health and Aging Study I). Participants: 554 women without severe walking disability (inability towalk or walking speed <0.4 m/s) at baseline. Main outcome measure:Incidence of severe walking disability assessed every 6 months over 3 years. Results: 155 women (27.9%) developed severe walking disability during follow-up. Rates of development of severe walking disability per 100 person-years among women in the lowest and in the three upper quartiles of total carotenoids were, respectively, 13.8 versus 10.9 (P = 0.0017). Adjusting for confounders, women in the lowest quartile of total carotenoids were more likely to develop severe walking disability (hazards ratio 1.57, 95% confidence interval 1.24-2.00, P = 0.0002) compared with women in the three upper quartiles. Conclusion: Low serum carotenoid levels, an indicator of low intake of fruits and vegetables, are independent predictors of the progression towards severe walking disability among older women living in the community.