Frailty and Vitamin D – with influence diagram Miller Oct 2010

Slide show Presented Oct 29, 2010
Discusses many different Frailty scales, and likes the following simple one.


• Fatigue (by self-report)
• Resistance (reported inability to walk up 10 steps without stopping)
• Ambulation (reported inability to walk ¼ mile on own without aids)
• Illnesses (more than 5 illnesses)
• Loss of weight (reported 10+ lb of wt loss in past year)

Over half of the slides are on the topic of Vitamin D


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following research did not find a problem after 4.6 years - wonder why

Circulating 25-Hydroxyvitamin D Levels and Frailty in Older Men: The Osteoporotic Fractures in Men Study.

J Am Geriatr Soc. 2011 Jan;59(1):101-106. doi: 10.1111/j.1532-5415.2010.03201.x. Epub 2010 Dec 16.
Ensrud KE, Blackwell TL, Cauley JA, Cummings SR, Barrett-Connor E, Dam TT, Hoffman AR, Shikany JM, Lane NE, Stefanick ML, Orwoll ES, Cawthon PM; for the Osteoporotic Fractures in Men Study Group.

From the Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MinnesotaDepartment of MedicineDivision of Epidemiology and Community Health, University of Minnesota, Minneapolis, MinnesotaCalifornia Pacific Medical Center Research Institute, San Francisco, CaliforniaDivision of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; Departments ofEpidemiologyFamily and Preventive Medicine, University of California at San Diego, La Jolla, CaliforniaDepartment of Medicine, Columbia University, New York, New YorkDepartment of Medicine, Stanford University, Stanford, CaliforniaDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AlabamaCenter for Healthy Aging and Division of Medicine, University of California at Davis, Davis, CaliforniaBone and Mineral Unit, Oregon Health & Science University, Portland, Oregon.

OBJECTIVES: To determine the cross-sectional and longitudinal associations between 25-hydroxyvitamin D (25(OH)D) levels and frailty status in older men.

DESIGN: Prospective cohort study.

SETTING: Six U.S. community-based centers.

PARTICIPANTS: One thousand six hundred six men aged 65 and older.

MEASUREMENTS: 25(OH)D (liquid chromatography tandem mass spectroscopy) and frailty status (criteria similar to those used in the Cardiovascular Health Study) measured at baseline; frailty status assessment repeated an average of 4.6 years later. Frailty status was classified as robust, intermediate, or frail at baseline and robust, intermediate, frail, or dead at follow-up.

RESULTS: After adjusting for multiple potential confounders, men with 25(OH)D levels less than 20.0?ng/mL had 1.5 times higher odds (multivariate odds ratio (MOR)=1.47, 95% confidence interval (CI)=1.07-2.02) of greater frailty status at baseline than men with 25(OH)D levels of 30.0?ng/mL or greater (referent group), whereas frailty status was similar in men with 25(OH)D levels from 20.0 to 29.9?ng/mL and those with levels of 30.0?ng/mL or greater (MOR=1.02, 95% CI=0.78-1.32). However, in 1,267 men not classified as frail at baseline, there was no association between lower baseline 25(OH)D level and odds of greater frailty status at the 4.6-year follow-up. Findings were the same when 25(OH)D was expressed in quartiles or as a continuous variable.

CONCLUSION: Lower levels of 25(OH)D (<20.0?ng/mL) in community-dwelling older men were independently associated with greater evidence of frailty at baseline but did not predict greater risk of greater frailty status at 4.6 years.
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society. PMID: 21226680

See also at VitaminDWiki

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