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

Abstract

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.

Effect of whey protein supplementation after resistance exercise on the muscle mass and physical function of healthy older women: A randomized controlled trial

“…27,28 We could not evaluate biomarkers of serum vitamin D related to muscle strength, in our participants. 29 Future exercise and nutritional supplementation studies will need to include measurements of vitamin D status. There is current evidence of a positive effect of a supplementation of approximately 2500-2800 mg of leucine in increasing the rate of muscle protein synthesis in healthy older individuals.…”

Vitamin D Deficiency and Sarcopenia in Older Persons

“…A relevant number of epidemiological studies have suggested the potential role of vitamin D in order to maintain or improve muscle strength and function, physical performance and preserve independence in older people [14,15]. Although, the biological role of vitamin D on skeletal muscles function has been widely investigated [16,17], in the past years the expression of VDR on skeletal muscle cells has been questioned.…”

“…Many prospective studies have examined the vitamin D role in muscle strength and physical performance in older adults [34,35,[38][39][40][41][42], although they differ in participants characteristics and type of muscle strength assessment. Several studies have shown as in older people, that serum levels of vitamin D are independently related to the loss of muscle mass and muscle strength decline [34,64], more in men than in women [17,65], suggesting that older people with vitamin D deficiency are extremely exposed to develop sarcopenia. A prospective study published in 2017 has shown that low circulating vitamin D levels are associated to an accelerated loss of muscle strength (measured as hand grip strength) in men ≥ 85 years; conversely, no significant differences have been found in physical performance, assessed by TUG, over time [66].…”

Vitamin D is related to handgrip strength in adult men aged 50 years and over: A population study from the TCLSIH cohort study

“…Previous studies have demonstrated a positive relationship between 25(OH)D levels and HGS in old males. 12,13,23,24 However, no association between serum 25(OH)D concentration and HGS was found in a study of 1219 males aged 30-79 years 14 and another study of males and females aged 20-76 years. 15 The reason for these conflicting findings may stem from the age range of participants being very broad.…”

“…However, results in the literature have not reached a consensus. Among older adults, many of the studies have reported a positive relationship between vitamin D status and HGS, 12,13 but this result cannot be found in the studies performed in participants with a broad age range. 14,15 Since HGS begins attenuating after 50 years of age, 8 we hypothesized that vitamin D is more beneficial to the maintenance of HGS in adults aged above 50 years than adults that are younger.…”