title: Markers of B-vitamin deficiency and frailty in older women.
abstract: OBJECTIVE
  To evaluate the association between markers of vitamins B12, B6 and folate deficiency and the geriatric syndrome of frailty.
  
  
  METHODS
  Cross-sectional study of baseline measures from the combined Women's Health and Aging Studies.
  
  
  METHODS
  Baltimore, Maryland.
  
  
  METHODS
  Seven hundred three community-dwelling women, aged 70-79.
  
  
  METHODS
  Frailty was defined by five-component screening criteria that include weight, grip strength, endurance, physical activity and walking speed measurements and modeled as binary and 3-level polytomous outcomes. Independent variables serum vitamin B6, vitamin B12, methylmalonic acid, total homocysteine, cystathionine and folate were modeled continuously and as abnormal versus normal.
  
  
  RESULTS
  Serum biomarker levels varied significantly by race. All analyses were race-stratified and results are reported only for Caucasian women due to small African American sample size. In polytomous logistic regression models of 3-level frailty, Caucasian women with increasing MMA, defined either continuously or using a predefined threshold, had 40-60% greater odds of being prefrail (p-values < 0.07) and 1.66-2.33 times greater odds of being frail (p-values < 0.02) compared to nonfrails after adjustment for age, education, low serum carotenoids, alcohol intake, cardiovascular disease and renal impairment. Both binary and polytomous frailty models evaluating vitamin B12 as the main exposure estimated odds ratios that were similar in trend yet slightly less significant than the MMA results.
  
  
  CONCLUSIONS
  These results suggest that vitamin B12 deficiency may contribute to the frailty syndrome in community-dwelling older women. Future studies are needed to explore these relationships longitudinally.
authors.affiliation: Johns Hopkins Institutions, Baltimore, MD, USA. amatteini@jhmi.edu
authors.forename: A M
authors.initials: AM
authors.lastname: Matteini
authors.forename: J D
authors.initials: JD
authors.lastname: Walston
authors.forename: M D
authors.initials: MD
authors.lastname: Fallin
authors.forename: K
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: W H L
authors.initials: WH
authors.lastname: Kao
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: R H
authors.initials: RH
authors.lastname: Allen
authors.forename: J
authors.initials: J
authors.lastname: Guralnik
authors.forename: L P
authors.initials: LP
authors.lastname: Fried
authors.forename: S P
authors.initials: SP
authors.lastname: Stabler
mesh_terms: D001741:Black or African American; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D006801:Humans; D044342:Malnutrition / Q000097:blood* / Q000453:epidemiology; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D014803:Vitamin B Complex / Q000097:blood*; D014804:Vitamin B Deficiency / Q000453:epidemiology*; D044465:White People; D016387:Women's Health
chemical_list: D015415:Biomarkers; D014803:Vitamin B Complex