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Risk of Frailty reduced 4X by 4,000 IU of vitamin D – RCT April 2022

The effects of vitamin D supplementation on frailty in older adults at risk for falls

BMC Geriatrics volume 22, Article number: 312 (2022)
Yurun Cai, Amal A. Wanigatunga, Christine M. Mitchell, Jacek K. Urbanek, Edgar R. Miller III, Stephen P. Juraschek, Erin D. Michos, Rita R. Kalyani, David L. Roth, Lawrence J. Appel & Jennifer A. Schrack

Risks if initially had 20-29 ng level of vitamin D
Low serum 25-hydroxyvitamin D [25(OH)D] level is associated with a greater risk of frailty, but the effects of daily vitamin D supplementation on frailty are uncertain. This secondary analysis aimed to examine the effects of vitamin D supplementation on frailty using data from the Study To Understand Fall Reduction and Vitamin D in You (STURDY).

The STURDY trial, a two-stage Bayesian, response-adaptive, randomized controlled trial, enrolled 688 community-dwelling adults aged ≥ 70 years with a low serum 25(OH)D level (10–29 ng/mL) and elevated fall risk. Participants were initially randomized to 200 IU/d (control dose; n = 339) or a higher dose (1000 IU/d, 2000 IU/d, or 4000 IU/d; n = 349) of vitamin D3. Once the 1000 IU/d was selected as the best higher dose, other higher dose groups were reassigned to the 1000 IU/d group and new enrollees were randomized 1:1 to 1000 IU/d or control group. Data were collected at baseline, 3, 12, and 24 months. Frailty phenotype was based on number of the following conditions: unintentional weight loss, exhaustion, slowness, low activity, and weakness (≥ 3 conditions as frail, 1 or 2 as pre-frail, and 0 as robust). Cox proportional hazard models estimated the risk of developing frailty, or improving or worsening frailty status at follow-up. All models were adjusted for demographics, health conditions, and further stratified by baseline serum 25(OH)D level (insufficiency (20–29 ng/mL) vs. deficiency (10–19 ng/mL)).

Among 687 participants (mean age 77.1 ± 5.4, 44% women) with frailty assessment at baseline, 208 (30%) were robust, 402 (59%) were pre-frail, and 77 (11%) were frail. Overall, there was no significant difference in risk of frailty outcomes comparing the pooled higher doses (PHD; ≥ 1000 IU/d) vs. 200 IU/d. When comparing each higher dose vs. 200 IU/d, the 2000 IU/d group had nearly double the risk of worsening frailty status (HR = 1.89, 95% CI: 1.13–3.16), while the 4000 IU/d group had a lower risk of developing frailty (HR = 0.22, 95% CI: 0.05–0.97). There were no significant associations between vitamin D doses and frailty status in the analyses stratified by baseline serum 25(OH)D level.

High dose vitamin D supplementation did not prevent frailty. Significant subgroup findings might be the results of type 1 error.

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VitaminDWiki pages with FRAILITY in title (16 as of Sept 2022)

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There Is No Magic Pill to Prevent Frailty—You Still Have to Eat Your Vegetables (nope) - Sept 2022

JAMA Open Network
"The Mediterranean diet has been shown to reduce incident frailty, with a pooled odds ratio of 0.44 for individuals who are most adherent to the diet."

  • which is half as good as the odds ratio of 0.22 for the Vitamin D study on this page
  • They state that Vitamin D does not work based on a study that used only 2,000 IU of vitamin D

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VitamaminDWiki - Falls and Fractures category



Created by admin. Last Modification: Saturday September 17, 2022 13:55:45 GMT-0000 by admin. (Version 10)

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ID Name Comment Uploaded Size Downloads
18438 No Magic Pill.pdf PDF 2022 admin 17 Sep, 2022 13:50 222.07 Kb 120
17384 Fraility insufficient.jpg admin 10 Apr, 2022 14:41 58.30 Kb 263
17383 Fraility.pdf PDF 2022 admin 10 Apr, 2022 14:39 1.24 Mb 186