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 H.M.
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 - Funding Information:
Conflict of Interest: Per the conflict of interest checklist provided by the authors, the authors have no relevant conflicts of interest with this paper. Funding: Mr. Buta, Dr. Xue, Dr. Bandeen-Roche, Dr. Walston, and Dr. Gross were supported by P30AG021334 (Johns Hopkins Older Americans Independence Center, which is funded by the National Institute on Aging (NIA), National Institutes of Health (NIH)). Dr. Semba was supported by R01AG027012 (NIA, NIH). Dr. McAdams-DeMarco was supported by K01AG043501 (NIA, NIH). Dr. Kalyani was supported by K23DK093583 (National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH). Author Contributions: Buta, Choudhury, Xue, and Kalyani developed the study design, reviewed the literature, interpreted data, led the writing of the manuscript, and created the tables and figure. Choudhury and Xue performed the data analyses. All other authors contributed to the design, interpretation of results, and writing. Sponsor's Role: The study sponsors had no role in the study's design, analysis, interpretation of data, or in the writing of the report or in the decision to submit the paper for publication.
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 -