TY - JOUR
T1 - The Association of Vitamin D Deficiency and Incident Frailty in Older Women
T2 - The Role of Cardiometabolic Diseases
AU - Buta, Brian
AU - Choudhury, Parichoy Pal
AU - Xue, Qian Li
AU - Chaves, Paulo
AU - Bandeen-Roche, Karen
AU - Shardell, Michelle
AU - Semba, Richard D.
AU - Walston, Jeremy
AU - Michos, Erin D.
AU - Appel, Lawrence J.
AU - McAdams-DeMarco, Mara
AU - Gross, Alden
AU - Yasar, Sevil
AU - Ferrucci, Luigi
AU - Fried, Linda P.
AU - Kalyani, Rita Rastogi
N1 - Publisher Copyright:
© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objectives: Evidence suggests vitamin D deficiency is associated with developing frailty. However, cardiometabolic factors are related to both conditions and may confound and/or mediate the vitamin D–frailty association. We aimed to determine the association of vitamin D concentration with incidence of frailty, and the role of cardiometabolic diseases (cardiovascular disease, diabetes, hyperlipidemia, hypertension) in this relationship. Design: Prospective longitudinal cohort study (7 visits from 1994–2008). Setting: Baltimore, Maryland. Participants: Three hundred sixty-nine women from the Women's Health and Aging Study II aged 70–79 years, free of frailty at baseline. Measurements: Serum circulating 25-hydroxyvitamin D (25[OH]D) concentration was assessed at baseline and categorized as: <10; 10–19.9; 20-29.9; and ≥30 ng/mL. Frailty incidence was determined based on presence of three or more criteria: weight loss, low physical activity, exhaustion, weakness, and slowness. Cardiometabolic diseases were ascertained at baseline. Analyses included Cox regression models adjusted for key covariates. Results: Incidence rate of frailty was 32.2 per 1,000 person-years in participants with 25(OH)D < 10 ng/mL, compared to 12.9 per 1,000 person-years in those with 25(OH)D ≥ 30 ng/mL (mean follow-up = 8.5 ± 3.7 years). In cumulative incidence analyses, those with lower 25(OH)D exhibited higher frailty incidence, though differences were non-significant (P =.057). In regression models adjusted for demographics, smoking, and season, 25(OH)D < 10 ng/mL (vs ≥30 ng/mL) was associated with nearly three-times greater frailty incidence (hazard ratio (HR) = 2.77, 95% CI = 1.14, 6.71, P =.02). After adjusting for BMI, the relationship of 25(OH)D < 10 ng/mL (vs ≥30 ng/mL) with incident frailty persisted, but was attenuated after further accounting for cardiometabolic diseases (HR = 2.29, 95% CI = 0.92, 5.69, P =.07). Conclusion: Low serum vitamin D concentration is associated with incident frailty in older women; interestingly, the relationship is no longer significant after accounting for the presence of cardiometabolic diseases. Future studies should explore mechanisms to explain this relationship.
AB - Objectives: Evidence suggests vitamin D deficiency is associated with developing frailty. However, cardiometabolic factors are related to both conditions and may confound and/or mediate the vitamin D–frailty association. We aimed to determine the association of vitamin D concentration with incidence of frailty, and the role of cardiometabolic diseases (cardiovascular disease, diabetes, hyperlipidemia, hypertension) in this relationship. Design: Prospective longitudinal cohort study (7 visits from 1994–2008). Setting: Baltimore, Maryland. Participants: Three hundred sixty-nine women from the Women's Health and Aging Study II aged 70–79 years, free of frailty at baseline. Measurements: Serum circulating 25-hydroxyvitamin D (25[OH]D) concentration was assessed at baseline and categorized as: <10; 10–19.9; 20-29.9; and ≥30 ng/mL. Frailty incidence was determined based on presence of three or more criteria: weight loss, low physical activity, exhaustion, weakness, and slowness. Cardiometabolic diseases were ascertained at baseline. Analyses included Cox regression models adjusted for key covariates. Results: Incidence rate of frailty was 32.2 per 1,000 person-years in participants with 25(OH)D < 10 ng/mL, compared to 12.9 per 1,000 person-years in those with 25(OH)D ≥ 30 ng/mL (mean follow-up = 8.5 ± 3.7 years). In cumulative incidence analyses, those with lower 25(OH)D exhibited higher frailty incidence, though differences were non-significant (P =.057). In regression models adjusted for demographics, smoking, and season, 25(OH)D < 10 ng/mL (vs ≥30 ng/mL) was associated with nearly three-times greater frailty incidence (hazard ratio (HR) = 2.77, 95% CI = 1.14, 6.71, P =.02). After adjusting for BMI, the relationship of 25(OH)D < 10 ng/mL (vs ≥30 ng/mL) with incident frailty persisted, but was attenuated after further accounting for cardiometabolic diseases (HR = 2.29, 95% CI = 0.92, 5.69, P =.07). Conclusion: Low serum vitamin D concentration is associated with incident frailty in older women; interestingly, the relationship is no longer significant after accounting for the presence of cardiometabolic diseases. Future studies should explore mechanisms to explain this relationship.
KW - aging
KW - cardiometabolic diseases
KW - frailty
KW - vitamin D
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U2 - 10.1111/jgs.14677
DO - 10.1111/jgs.14677
M3 - Article
C2 - 28008596
AN - SCOPUS:85007071984
SN - 0002-8614
VL - 65
SP - 619
EP - 624
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 3
ER -