title: Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: the Invecchiare in Chianti Study.
abstract: OBJECTIVE
  To assess whether serum 25-hydroxyvitamin D (25(OH)D) concentrations relate to transitions between the states of robustness, prefrailty, and frailty and to mortality in older adults.
  
  
  METHODS
  The Invecchiare in Chianti (InCHIANTI) Study, a prospective cohort study.
  
  
  METHODS
  Tuscany, Italy.
  
  
  METHODS
  Adults aged 65 and older (N = 1,155).
  
  
  METHODS
  Serum 25(OH)D concentrations measured at baseline; frailty state (robust, prefrail, frail) assessed at baseline and 3 and 6 years after enrollment; and vital status determined 3 and 6 years after enrollment.
  
  
  RESULTS
  The median (interquartile range) 25(OH)D concentration was 16.0 ng/mL (10.4-25.6 ng/mL; multiply by 2.496 to convert to nmol/L). Prefrail participants with 25(OH)D levels less than 20 ng/mL were 8.9% (95% confidence interval (CI) = 2.5-15.2%) more likely to die, 3.0% (95% CI = -5.6-14.6%) more likely to become frail, and 7.7% (95% CI = -3.5-18.7%) less likely to become robust than prefrail participants with 25(OH)D levels of 20 ng/mL or more. In prefrail participants, each 5-ng/mL decrement of continuous 25(OH)D was associated with 1.46 times higher odds of dying (95% CI = 1.18-2.07) and 1.13 higher odds of incident frailty (95% CI = 0.90-1.39) than with recovery of robustness. Transitions from robustness or frailty were not associated with 25(OH)D levels.
  
  
  CONCLUSIONS
  Results provide evidence that prefrailty is an "at risk" state from which older adults with high 25(OH)D levels are more likely to recover than to decline, but high 25(OH)D levels were not associated with recovery from frailty. Thus, 25(OH)D levels should be investigated as a potential therapy to treat prefrailty and prevent further decline.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA. mshardel@epi.umaryland.edu
authors.forename: Michelle
authors.initials: M
authors.lastname: Shardell
authors.forename: Christopher
authors.initials: C
authors.lastname: D'Adamo
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Alley
authors.forename: Ram R
authors.initials: RR
authors.lastname: Miller
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Hicks
authors.forename: Yuri
authors.initials: Y
authors.lastname: Milaneschi
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009026:Mortality; D011379:Prognosis; D011446:Prospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D