Vitamin D and Physical Performance in Elderly Subjects: The Pro.V.A Study

Abstract

BackgroundThe role of Vitamin D in musculoskeletal functionality among elderly people is still controversial. We investigated the association between serum 25-hydroxyvitamin D (25OHD) levels and physical performance in older adults.Methods2694 community-dwelling elderly women and men from the Progetto Veneto Anziani (Pro.V.A.) were included. Physical performances were assessed by: tandem test, 5 timed chair stands (TCS), gait speed, 6-minute walking (6 mW) distance, handgrip strength, and quadriceps strength. For each test, separate general linear models and loess plots were obtained in both genders, in relation to serum 25OHD concentrations, controlling for several potential confounders.ResultsLinear associations with 25OHD levels were observed for TCS, gait speed, 6 mW test and handgrip strength, but not for tandem test and quadriceps strength. After adjusting for potential confounders, linear associations with 25OHD levels were still evident for the 6 mW distance in both genders (p = .0002 in women; <.0001 in men), for TCS in women (p = .004) and for gait speed (p = .0006) and handgrip strength (p = .03) in men. In loess analyses, performance in TCS in women, in gait speed and handgrip strength in men and in 6 mW in both genders, improved with increasing levels of 25OHD, with most of the improvements occurring for 25OHD levels from 20 to 100 nmol/L.Conclusionlower 25OHD levels are associated with a worse coordination and weaker strength (TCS) in women, a slower walking time and a lower upper limb strength in men, and a weaker aerobic capacity (6 mW) in both genders. For optimal physical performances, 25OHD concentrations of 100 nmol/L appear to be more advantageous in elderly men and women, and Vitamin D supplementation should be encouraged to maintain their 25OHD levels as high as this threshold.

Calcifediol versus vitamin D3 effects on gait speed and trunk sway in young postmenopausal women: a double-blind randomized controlled trial

“…A similar association was seen in 2694 community-dwelling seniors age 65 and older from Italy. Compared to the lowest quintile of 25(OH)D, the highest quintile showed an average improvement in gait speed by 21 % in both men and women (test for trend: p<0.0001)[7]. Similarly, in the EPIDOS study, both usual and fast walking speed was associated with 25(OH)D status.…”

“…Several cross-sectional studies found an association between higher 25(OH)D level and greater gait speed [5][6][7][8][9][10]. However, a recent trial-level meta-analysis of clinical trials could not confirm this association based on limited data from three trials that tested gait speed as an endpoint [11].…”

Vitamin D deficiency in myotonic dystrophy type 1

“…The 25(OH)D reduction in DM1 could be due to an impaired skin production of cholecalciferol rather than a defective liver hydroxylation. Vitamin D administration has been described to improve physical performance in elderly subjects [19,20]. Therefore, vitamin D supplementation should be considered in DM1 patients to prevent endocrine and bone modification due to vitamin D deficit, and in the attempt to increase IGF1 levels and to ameliorate muscle performance.…”

Hypovitaminosis D is associated with a reduction in upper and lower limb muscle strength and physical performance in post-menopausal women: a retrospective study

“…The relationship between serum 25-hydroxy-vitamin D [25(OH)D 3 ] levels and muscle strength has been extensively investigated, even though there is no agreement in literature [13], given several studies supporting it [14][15][16][17][18] and others denying this association [19,20]. Moreover, to the best of our knowledge there is only a study that investigated the association between serum 25(OH)D 3 levels and physical performance, involving both upper and lower extremities, in older adults [18].…”

“…Moreover, to the best of our knowledge there is only a study that investigated the association between serum 25(OH)D 3 levels and physical performance, involving both upper and lower extremities, in older adults [18].…”