title: 25-hydroxyvitamin D and increased all-cause mortality in very old women: the Newcastle 85+ study.
abstract: OBJECTIVE
  To investigate the associations between low and high concentrations of baseline serum 25-hydroxyvitamin D [25(OH)D] and all-cause mortality in very old (≥85 years) men and women over 6 years.
  
  
  METHODS
  Prospective mortality data from 775 participants in the Newcastle 85+ Study were analysed for survival in relation to 25(OH)D (season-specific quartiles and predefined cut-off values) and sex using Cox proportional hazards models. The models were fitted to the entire and restricted (nonusers of vitamin D-containing supplements and medication) cohorts.
  
  
  RESULTS
  For the entire cohort, mortality was higher in both the lowest and highest 25(OH)D season-specific quartiles [SQ1: hazard ratio (HR) 1.31, 95% confidence interval (CI) 1.01-1.69, P = 0.04; SQ4: HR 1.44, 95% CI 1.12-1.85, P = 0.004] compared with the combined middle quartiles (SQ2 + SQ3), after adjustment for sociodemographic factors. The increased risk for the highest quartile remained significant after further adjustment for lifestyle variables (SQ4: HR 1.37, 95% CI 1.06-1.77, P = 0.02) and was seen only in women in sex-specific analyses. Similarly, in sensitivity analyses with predefined 25(OH)D cut-off values, the highest 25(OH)D concentration (≥75 nmol L(-1) ) was associated with a 2.4-fold increased risk of mortality in women (restricted cohort) after adjusting for all covariates.
  
  
  CONCLUSIONS
  Low and high season-specific 25(OH)D quartiles were associated with increased risks of mortality over 6 years in the very old; this effect was particularly noticeable in women, including those who reported taking vitamin D-containing supplements/medication.
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: A
authors.initials: A
authors.lastname: Granic
authors.forename: T
authors.initials: T
authors.lastname: Aspray
authors.forename: T
authors.initials: T
authors.lastname: Hill
authors.forename: K
authors.initials: K
authors.lastname: Davies
authors.forename: J
authors.initials: J
authors.lastname: Collerton
authors.forename: C
authors.initials: C
authors.lastname: Martin-Ruiz
authors.forename: T
authors.initials: T
authors.lastname: von Zglinicki
authors.forename: T B L
authors.initials: TB
authors.lastname: Kirkwood
authors.forename: J C
authors.initials: JC
authors.lastname: Mathers
authors.forename: C
authors.initials: C
authors.lastname: Jagger
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: ageing; cohort study; mortality; risk factor; vitamins; women's health