25‐hydroxyvitamin <scp>D</scp> and increased all‐cause mortality in very old women: the <scp>N</scp>ewcastle 85+ study

Granic, Antoneta; Aspray, Terry; Hill, Thomas; Davies, Karen; Collerton, Joanna; Martin-Ruiz, Carmen; Zglinicki, Thomas von; Kirkwood, Thomas B. L.; Mathers, John C.; Jagger, Carol

doi:10.1111/joim.12273

Cited by 22 publications

(37 citation statements)

References 41 publications

(99 reference statements)

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“…Even though it has been found in several studies in elderly people aged 85 years or older, 3 hypovitaminosis D – which was showen in more than a half of our participants aged 85 years at baseline 27 – was not able by itself to demonstrate association with mortality at either 3 years, 19 nor at 5 years of follow-up. Moreover, an inverted CD4:CD8 ratio as an immune risk phenotype has been correlated with survival rates in elderly people; 28 however, after 5 years of follow-up, these results could not be confirmed in our cohort of elderly community residents, as it had also not been shown during the first 3 years of follow-up.…”

Section: Discussioncontrasting

confidence: 87%

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Evidence of functional declining and global comorbidity measured at baseline proved to be the strongest predictors for long-term death in elderly community residents aged 85 years: a 5-year follow-up evaluation, the OCTABAIX study

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et al. 2016

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ObjectiveTo investigate the predictive value of functional impairment, chronic conditions, and laboratory biomarkers of aging for predicting 5-year mortality in the elderly aged 85 years.MethodsPredictive value for mortality of different geriatric assessments carried out during the OCTABAIX study was evaluated after 5 years of follow-up in 328 subjects aged 85 years. Measurements included assessment of functional status comorbidity, along with laboratory tests on vitamin D, cholesterol, CD4/CD8 ratio, hemoglobin, and serum thyrotropin.ResultsOverall, the mortality rate after 5 years of follow-up was 42.07%. Bivariate analysis showed that patients who survived were predominantly female (P=0.02), and they showed a significantly better baseline functional status for both basic (P<0.001) and instrumental (P<0.001) activities of daily living (Barthel and Lawton index), better cognitive performance (Spanish version of the Mini-Mental State Examination) (P<0.001), lower comorbidity conditions (Charlson) (P<0.001), lower nutritional risk (Mini Nutritional Assessment) (P<0.001), lower risk of falls (Tinetti gait scale) (P<0.001), less percentage of heart failure (P=0.03) and chronic obstructive pulmonary disease (P=0.03), and took less chronic prescription drugs (P=0.002) than nonsurvivors. Multivariate Cox regression analysis identified a decreased score in the Lawton index (hazard ratio 0.86, 95% confidence interval: 0.78–0.91) and higher comorbidity conditions (hazard ratio 1.20, 95% confidence interval: 1.08–1.33) as independent predictors of mortality at 5 years in the studied population.ConclusionThe ability to perform instrumental activities of daily living and the global comorbidity assessed at baseline were the predictors of death, identified in our 85-year-old community-dwelling subjects after 5 years of follow-up.

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confidence: 87%

“…Despite the increasing number of oldest old population worldwide, longitudinal studies specifically designed to assess mortality in subjects aged over 85 years (the current fastest growing population subgroup in many countries) are still scarce in medical literature. 1 – 3 …”

Section: Introductionmentioning

confidence: 99%

Evidence of functional declining and global comorbidity measured at baseline proved to be the strongest predictors for long-term death in elderly community residents aged 85 years: a 5-year follow-up evaluation, the OCTABAIX study

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et al. 2016

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“…The IOM also highlighted the emergence of evidence of a non-linear relationship between 25(OH)D and several extraskeletal outcomes [21], which we have reported for global cognition, attention [22], and mortality [23] in the very old. Greater benefits for cognition and longevity in this cohort were observed at concentrations between 40–60 nmol/L [22,23].…”

Section: Discussionmentioning

confidence: 79%

Vitamin D Status, Muscle Strength and Physical Performance Decline in Very Old Adults: A Prospective Study

et al. 2017

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Mixed reports exist about the role of 25-hydroxyvitamin D (25(OH)D) in muscle ageing and there are few prospective studies involving the very old (aged ≥ 85) who are at highest risk of low 25(OH)D, loss of muscle mass and strength, and physical performance decline. In the Newcastle 85+ Study (n = 845), we aimed to determine the association between 25(OH)D season-specific quartiles (hereafter SQ1–SQ4), grip strength (GS) and physical performance decline (Timed Up-and-Go Test, TUG) over 5 years using mixed models. In the time-only models with linear and quadratic slopes, SQ1 and SQ4 of 25(OH)D were associated with weaker GS initially in men (SQ1: β (SE) = −2.56 (0.96); SQ4: −2.16 (1.06)) and women (SQ1: −1.10 (0.52); SQ4: −1.28 (0.50)) (all p ≤ 0.04). In the fully adjusted models, only men in SQ1 had a significant annual decline in GS of 1.41 kg which accelerated over time (−0.40 (0.1)), (both p ≤ 0.003) compared with those in combined middle quartiles. Only women in SQ1 and SQ4 of 25(OH)D had worse TUG times initially, but the rate of TUG decline was not affected. Low baseline 25(OH)D may contribute to muscle strength decline in the very old and particularly in men.

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“…This lack of association may be due to the age of our participants, reduced power to detect the association, specific definition of cognitive change at an individual level, and/or changed serum 25(OH)D status over the 3 years of the study. Increased mortality amongst older women belonging to the lowest and highest season‐specific 25(OH)D quartiles as observed in this cohort could be one of the reasons for the loss of analytical power. Incident impairment was defined as crossing the 25‐point threshold of SMMSE .…”

Section: Discussionmentioning

confidence: 83%

Serum 25‐hydroxyvitamin D and cognitive decline in the very old: the Newcastle 85+ Study

Granic

Hill

Kirkwood

et al. 2014

Euro J of Neurology

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Background and purposeStudies investigating the association between 25-hydroxyvitamin D [25(OH)D] and cognition in the very old (85+) are lacking.MethodsCross-sectional (baseline) and prospective data (up to 3 years follow-up) from 775 participants in the Newcastle 85+ Study were analysed for global (measured by the Standardized Mini-Mental State Examination) and attention-specific (measured by the attention battery of the Cognitive Drug Research test) cognitive performance in relation to season-specific 25(OH)D quartiles.ResultsThose in the lowest and highest season-specific 25(OH)D quartiles had an increased risk of impaired prevalent (1.66, 95% confidence interval 1.06–2.60, P = 0.03; 1.62, 95% confidence interval 1.02–2.59, P = 0.04, respectively) but not incident global cognitive functioning or decline in functioning compared with those in the middle quartiles adjusted for sociodemographic, health and lifestyle confounders. Random effects models showed that participants belonging to the lowest and highest 25(OH)D quartiles, compared with those in the middle quartiles, had overall slower (log-transformed) attention reaction times for Choice Reaction Time (lowest, β = 0.023, P = 0.01; highest, β = 0.021, P = 0.02), Digit Vigilance Task (lowest, β = 0.009, P = 0.05; highest, β = 0.01, P = 0.02) and Power of Attention (lowest, β = 0.017, P = 0.02; highest, β = 0.022, P = 0.002) and greater Reaction Time Variability (lowest, β = 0.021, P = 0.02; highest, β = 0.02, P = 0.03). The increased risk of worse global cognition and attention amongst those in the highest quartile was not observed in non-users of vitamin D supplements/medication.ConclusionLow and high season-specific 25(OH)D quartiles were associated with prevalent cognitive impairment and poorer overall performance in attention-specific tasks over 3 years in the very old, but not with global cognitive decline or incident impairment.

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25‐hydroxyvitamin D and increased all‐cause mortality in very old women: the Newcastle 85+ study

Cited by 22 publications

References 41 publications

Evidence of functional declining and global comorbidity measured at baseline proved to be the strongest predictors for long-term death in elderly community residents aged 85 years: a 5-year follow-up evaluation, the OCTABAIX study

Evidence of functional declining and global comorbidity measured at baseline proved to be the strongest predictors for long-term death in elderly community residents aged 85 years: a 5-year follow-up evaluation, the OCTABAIX study

Vitamin D Status, Muscle Strength and Physical Performance Decline in Very Old Adults: A Prospective Study

Serum 25‐hydroxyvitamin D and cognitive decline in the very old: the Newcastle 85+ Study

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