Vitamin K Status and Mobility Limitation and Disability in Older Adults: The Health, Aging, and Body Composition Study

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Vitamin K has been implicated in chronic diseases associated with increased risk for mobility disability, such as osteoarthritis and cardiovascular disease. However, the association between vitamin K status and mobility disability is unknown. Therefore, we examined the association between vitamin K status and incident mobility disability in the Health, Aging, and Body Composition Study.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Plasma phylloquinone (vitamin K1) was categorized as &amp;lt;0.5, 0.5–&amp;lt;1.0 and ≥1.0 nmol/L (n = 1,323, 48% male). Plasma ucMGP, which increases when vitamin K status is low, was measured in 716 participants and categorized into tertiles. Mobility limitation and disability, defined as two consecutive semiannual reports of having any or a lot of difficulty walking a one-fourth mile or climbing 10 steps without resting, were assessed over a median 6–10 years of follow-up. Multivariate Cox proportional hazard models were used to evaluate the association between vitamin K status and incident mobility limitation and disability.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Participants with plasma phylloquinone less than 0.5 nmol/L were more likely to develop mobility limitation and disability compared to those with at least 1.0 nmol/L (adjusted HR (95% CI) mobility limitation: 1.27 (1.05–1.53); disability: 1.34 (1.01–1.76)). After further adjustment for knee pain, the associations were partially attenuated (HR (95% CI) mobility limitation: 1.20 (0.99–1.45); disability: 1.26 (0.96–1.67)). Plasma ucMGP was not associated with incident mobility limitation, but was nonlinearly associated with incident mobility disability (HR (95% CI), compared to tertile 1: tertile 2 = 1.64 (1.19–2.27), tertile 3 = 1.17 (0.83–1.66), fully adjusted).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Our results suggest vitamin K may be involved in the disablement process in older age. Future studies are needed to confirm our findings and clarify the underlying mechanism.</jats:p> </jats:sec>

The Relationship between Vitamin K and Osteoarthritis: A Review of Current Evidence

“…Subsequent analysis of the Health ABC study showed that subjects (n = 1323; mean age 74.2 ± 2.8 years) with plasma phylloquinone level < 0.5 nmol/L were more likely to develop mobility limitations and disability, compared to those with at least 1.0 nmol/L plasma phylloquinone. On the other hand, plasma uncarboxylated MGP (n = 716) was associated with mobility disability in a non-linear fashion but was not associated with mobility limitation [35]. Shea et al also analysed the prospective data of Health ABC and Osteoarthritis Initiatives and found that adequate circulating phylloquinone level (≥ 1 nmol/L) and 25-hydroxyvitamin D (≥ 50 nmol/L) predicted better short physical performance battery scores and gait speed, in follow-up investigations.…”

“…In terms of mobility, the Health ABC study found that circulating vitamin K level (< 0.5 nmol/L) was associated with mobility limitation and disability, compared to those with a level > 1.0 nmol/L. The uncarboxylated MGP was not associated with both mobility variables [35].…”

Targeting Age-Dependent Functional and Metabolic Decline of Human Skeletal Muscle: The Geroprotective Role of Exercise, Myokine IL-6, and Vitamin D

“…Vitamin K can suppress NF-kB signal transduction and ROS generation, likely through direct effects on muscle tissue. Older subjects with lower plasma vitamin K seem to retain higher mobility limitation and disability [64,65]. Vitamin D, classically classified as a steroid hormone, is well recognized to be a critical regulator for muscle function during all life spans, from intrauterine to late-phase life, due to anti-inflammatory, metabolic, and immunoregulatory actions, even though its antioxidant effect has been recently debated [66][67][68][69][70][71][72].…”

Vitamin K as a Powerful Micronutrient in Aging and Age-Related Diseases: Pros and Cons from Clinical Studies

“…Although no underlying mechanism is proposed, the results suggest the involvement of vitamin K in the disabling process associated with aging. Older adults with lower levels of plasma K1 were found to be more prone to develop mobility limitation and disability, compared to those with higher circulating levels [37]. In a prospective study involving 13 years of follow-up of 644 community-dwelling adults from the Longitudinal Aging Study Amsterdam (LASA) cohort, low baseline vitamin K status (high levels of circulating dp-ucMGP) was associated with a higher frailty index score in older aging people [38].…”

“…Recently, low vitamin K status has been associated with multiple co-morbidities, functional decline, disability and frailty in older adults [37,121], especially in those with associated OA and CVD [11,122]. In addition, inflammation accelerates ageing in individuals with multimorbidity, and further promotes the functional limitation and disability in the elderly [123].…”