Vitamin D deficiency and frailty in older Americans

Wilhelm-Leen, Emilee R.; Hall, Yoshio N.; DeBoer, Ian; Chertow, Glenn M.

doi:10.1111/j.1365-2796.2010.02248.x

Cited by 141 publications

(83 citation statements)

References 34 publications

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“…Taken together, these findings indicate that the association between low 25OHD values and orthostatic hypotension is more likely to relate to the fact that individuals with a poor vitamin D status also had more of the factors known to be associated with orthostatic hypotension. 30,31 Our findings are consistent with a recent work by McCarroll et al 11 demonstrating that 25OHD levels were significantly lower in patients with orthostatic hypotension, but they were not associated with impaired orthostatic hemodynamic parameters. The literature on the possible relationship between 25OHD and orthostatic hypotension in younger people is of limited value.…”

Section: Discussionsupporting

confidence: 83%

Serum 25-Hydroxyvitamin D and Orthostatic Hypotension in Old People

et al. 2014

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O rthostatic hypotension is a common condition in old people and increases exponentially with age. Among community-dwelling subjects aged >65 years, its prevalence is ≈20%, and in people aged >75 years, it is as high as 30%. 1Orthostatic hypotension is associated with significant cardiovascular morbidities, falls, fractures, and a higher mortality risk. Many factors are related to this condition, including age-associated changes in blood pressure regulation, rapid posture changes, autonomic insufficiency, cardiovascular diseases, or any acute illnesses involving fluid loss.1 Essential hypertension develops in ≈60% of individuals by the age of 60, but its characteristics in older people differ from those seen in the middle-aged, being associated more often with complications in the older-aged.2 Hypertension is one of the most common known risk factors for orthostatic hypotension in the elderly persons. 3Among the less studied risk factors for this orthostatic hypotension, poor vitamin D status is increasingly attracting interest because of recent research showing a strong relationship between serum 25-hydroxyvitamin D (25OHD) and blood pressure. 25OHD levels have been correlated with both the prevalence and the incidence of hypertension, and low 25OHD levels were found to be associated with higher diastolic and systolic blood pressure levels. [4][5][6][7][8][9] Vitamin D receptors are found in endothelial cells, suggesting a possible role for this vitamin in modulating vascular response during orthostatism. 10 McCarroll et al 11 found a significant difference in 25OHD levels between individuals with and without orthostatic hypotension and suggested a possible role for vitamin D status in the pathogenesis of this condition in old people. Research on this association in the elderly persons is lacking, however, and although Abstract-Interest in the association between serum 25-hydroxyvitamin D (25OHD) and blood pressure has increased because recent research showed a close relationship between them, but there is still little information on the possible association between 25OHD and orthostatic hypotension. The aim of this study was to explore the relationship of 25OHD levels with any presence of orthostatic hypotension in a large group of older people. This study was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study involving people aged >65 years. In this cross-sectional work, we considered 2640 (1081 men and 1559 women) with a mean age of 73.8±6.8 years. Orthostatic hypotension was defined as a drop of ≤20 mm Hg in systolic or ≤10 mm Hg in diastolic blood pressure <3 minutes of orthostatism. Orthostatic hypotension was identified in 32.2% of the sample. The prevalence of orthostatic hypotension was higher in individuals with 25OHD levels <50 nmol/L, but this trend was not significant (P=0.13). Individuals who had orthostatic hypotension had significantly lower 25OHD levels than those who did not (75.0±51.4 versus 82.6±54.0 nmol/L; P<0.0001). On logistic regression analysis, th...

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Section: Discussionsupporting

confidence: 83%

Serum 25-Hydroxyvitamin D and Orthostatic Hypotension in Old People

et al. 2014

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“…37 Bone health closely mirrored overall health: Frailty characterized over one out of four subjects in the lowest BMD cluster, but less than 1% of those in the highest BMD cluster. Frailty is an important marker of the risk of impending or worsening disability, hospitalization, and mortality.…”

Section: Discussionmentioning

confidence: 99%

Bone Health As a Function of Adipokines and Vitamin D Pattern in Elderly Patients

Pedone

Napoli

Pozzilli

et al. 2013

Rejuvenation Research

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Background: Adiponectin, leptin, and resistin are involved in bone metabolism, but the evidence regarding their effects is not conclusive. We analyzed the relationship between these adipokines, vitamin D, and bone health using a cluster analysis approach. Methods: We used cross-sectional data coming from the InCHIANTI study, in which bone density and area were estimated using computed tomography. The sample size was 690 (women, 57.5%; mean age, 75.2 years; range, 65-102). Five clusters were generated on the basis of gender, age, adipokines, and vitamin D concentrations. The clusters were characterized, respectively, by higher resistin and older age (hR-O, n = 134), higher vitamin D and younger age (hD-Y, n = 152), higher adiponectin (hA, n = 65), and higher leptin (hL, n = 52). The last cluster had intermediate values of all the constituting variables (I, n = 287). The clusters were compared with respect to bone parameters and clinical characteristics. Results: Cluster hR-O had the lowest total and cortical bone density. Cluster hD-Y had the lowest adiponectin (9.29 g/mL) and leptin (7.9 ng/mL) serum concentrations, the highest prevalence of men (71.1%), and total/ cortical bone density and area. No statistically significant difference across clusters was observed for age-and sex-standardized measures of bone mineral density and bone area, but leptin was associated with these parameters in a linear model adjusted for age, gender, vitamin D, resistin, and leptin. Conclusions: In an elderly population, age and sex almost completely explain the variability in bone status across cluster characterized by different levels of circulating adipokines and vitamin D. The role of leptin, however, seems worthy of consideration.

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“…Evidence supporting a role for vitamin D includes the fact that polymorphisms in vitamin D have been linked to muscle strength (39); also frailty (a condition which has some overlap with sarcopenia) has been shown to be associated with vitamin D deficiency (40). As with protein supplementation, intervention trials of the effect of vitamin D on strength and physical performance have shown mixed results, however (41).…”

Section: Dietmentioning

confidence: 99%

Sarcopenia

Dodds

Sayer

2014

Arq Bras Endocrinol Metab

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Sarcopenia, the loss of muscle mass and function with age, is highly relevant to clinical practice as it has been associated with a wide range of ageing outcomes including disability and shorter survival times. As such it is now a major focus for research and drug discovery. There has been recent progress in the development of consensus definitions for the diagnosis of sarcopenia, taking the form of measurements of muscle mass and strength or physical performance. These definitions form potential inclusion criteria for use in trials, although the optimum choice of outcome measures is less clear. Prevalence estimates using these new definitions vary, although they suggest that sarcopenia is a common (approximately 13% from one study) clinical problem in older people. A range of lifestyle factors have been investigated in regard to the development of this condition, and progressive resistance training is the most well-established intervention so far. There is also marked research interest in the role of diet, although so far the value of supplementation is less clear. Other potential treatments for sarcopenia include the angiotensin-converting enzyme inhibitors, with some evidence that they can improve physical performance in older people. Future research directions include an increased understanding of the molecular and cellular mechanisms of sarcopenia and the use of a life course approach to explore the possibility of earlier intervention and prevention. Arq Bras Endocrinol Metab. 2014;58(5):464-9 Keywords Sarcopenia; muscle mass; physical performance; aging ReSumoA sarcopenia, definida como a perda de função e massa muscular que ocorrem com a idade, é altamente relevante para a prática clínica, pois está associada a vários desfechos negativos, incluindo diminuição da funcionalidade e da sobrevida. Houve recente progresso no desenvolvimento de definições para o diagnóstico da sarcopenia, e estas atualmente se compõem tanto de medidas de massa e força muscular quanto do desempenho físico. Essas definições são potencialmente úteis como critérios de inclusão em pesquisas científicas, todavia a escolha de desfechos é menos clara. As estimativas de prevalência utilizando essas novas definições variam, mas elas sugerem que a sarcopenia é um problema clínico comum (cerca de 13% a partir de um estudo) em pessoas idosas. Uma série de fatores de estilo de vida foi investigada em relação ao desenvolvimento dessa condição, e o treinamento de resistência progressiva é a intervenção mais bem estabelecida até o momento. A intervenção dietética também foi aventada como um fator modificável, embora menos clara que a anterior. Outros tratamentos potenciais para sarcopenia incluem os inibidores da enzima conversora de angiotensina, com alguma evidência de que eles podem melhorar o desempenho físico em idosos. Pesquisas futuras que abordem uma maior compreensão dos mecanismos moleculares e celulares da sarcopenia, além de abordagens precoces que possam vir a modificar o surgimento da sarcopenia, são necessárias. Arq Bras E...

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Vitamin D deficiency and frailty in older Americans

Cited by 141 publications

References 34 publications

Serum 25-Hydroxyvitamin D and Orthostatic Hypotension in Old People

Serum 25-Hydroxyvitamin D and Orthostatic Hypotension in Old People

Bone Health As a Function of Adipokines and Vitamin D Pattern in Elderly Patients

Sarcopenia

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