title: Low vitamin D status is an independent predictor of increased frailty and all-cause mortality in older men: the Health in Men Study.
abstract: OBJECTIVE
  Hypovitaminosis D and frailty are common in the older population. We aimed to determine whether 25-hydroxyvitamin D [25(OH)D] concentrations are associated with frailty and mortality.
  
  
  METHODS
  We conducted a prospective cohort study.
  
  
  METHODS
  Participants included 4203 older men aged 70-88 years in Perth, Western Australia.
  
  
  METHODS
  25(OH)D was measured by immunoassay. Frailty was assessed with the 5-point FRAIL (fatigue, resistance, ambulation, illness, and loss of weight) scale. Mortality was determined from the death registry via the Western Australian Data Linkage System.
  
  
  RESULTS
  At baseline, 676 (16.1%) men were frail, as defined by having ≥3 deficits (FRAIL scale ≥ 3). In multivariate cross-sectional analysis, low vitamin D status, defined by the lowest quartile of 25(OH)D values (<52.9 nmol/L), was associated with increased prevalent frailty (odds ratio, 1.96; 95% confidence interval [CI], 1.52 to 2.52) in comparison to the highest quartile of 25(OH)D values (>81.6 nmol/L). After a mean period of 5.3 years, the adjusted odds ratio of being frail at follow-up for men with low vitamin D and having zero deficit at baseline (FRAIL scale = 0) was 1.56 (95% CI, 1.07 to 2.27). Low vitamin D also predicted all-cause mortality over a period of up to 9.2 years (hazard ratio, 1.20; 95% CI, 1.02 to 1.42), independent of baseline frailty and other covariates.
  
  
  CONCLUSIONS
  Hypovitaminosis D is associated with prevalent and incident frailty in older men. Hypovitaminosis D also predicts all-cause mortality, independent of frailty. The association between vitamin D and mortality is not solely dependent on the occurrence of frailty.
authors.affiliation: Western Australian Centre for Health and Ageing, Western Australia Institute for Medical Research, Crawley, Western Australia 6009, Australia.
authors.forename: Yuen Y E
authors.initials: YY
authors.lastname: Wong
authors.forename: Kieran A
authors.initials: KA
authors.lastname: McCaul
authors.forename: Bu B
authors.initials: BB
authors.lastname: Yeap
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000401:mortality*; D014904:Western Australia / Q000453:epidemiology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D