Dataset Information

Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study.

ABSTRACT: OBJECTIVES:To determine the cross-sectional and longitudinal associations between 25-hydroxyvitamin D (25(OH)D) levels and frailty status in older men. DESIGN:Prospective cohort study. SETTING:Six U.S. community-based centers. PARTICIPANTS:One thousand six hundred six men aged 65 and older. MEASUREMENTS:25(OH)D (liquid chromatography tandem mass spectroscopy) and frailty status (criteria similar to those used in the Cardiovascular Health Study) measured at baseline; frailty status assessment repeated an average of 4.6 years later. Frailty status was classified as robust, intermediate, or frail at baseline and robust, intermediate, frail, or dead at follow-up. RESULTS:After adjusting for multiple potential confounders, men with 25(OH)D levels less than 20.0 ng/mL had 1.5 times higher odds (multivariate odds ratio (MOR)=1.47, 95% confidence interval (CI)=1.07-2.02) of greater frailty status at baseline than men with 25(OH)D levels of 30.0 ng/mL or greater (referent group), whereas frailty status was similar in men with 25(OH)D levels from 20.0 to 29.9 ng/mL and those with levels of 30.0 ng/mL or greater (MOR=1.02, 95% CI=0.78-1.32). However, in 1,267 men not classified as frail at baseline, there was no association between lower baseline 25(OH)D level and odds of greater frailty status at the 4.6-year follow-up. Findings were the same when 25(OH)D was expressed in quartiles or as a continuous variable. CONCLUSION:Lower levels of 25(OH)D (<20.0 ng/mL) in community-dwelling older men were independently associated with greater evidence of frailty at baseline but did not predict greater risk of greater frailty status at 4.6 years.

SUBMITTER: Ensrud KE

PROVIDER: S-EPMC3343694 | biostudies-literature | 2011 Jan

REPOSITORIES: biostudies-literature

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Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study.

Ensrud Kristine E KE Blackwell Terri L TL Cauley Jane A JA Cummings Steven R SR Barrett-Connor Elizabeth E Dam Thuy-Tien L TT Hoffman Andrew R AR Shikany James M JM Lane Nancy E NE Stefanick Marcia L ML Orwoll Eric S ES Cawthon Peggy M PM

Journal of the American Geriatrics Society 20101216 1

<h4>Objectives</h4>To determine the cross-sectional and longitudinal associations between 25-hydroxyvitamin D (25(OH)D) levels and frailty status in older men.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Six U.S. community-based centers.<h4>Participants</h4>One thousand six hundred six men aged 65 and older.<h4>Measurements</h4>25(OH)D (liquid chromatography tandem mass spectroscopy) and frailty status (criteria similar to those used in the Cardiovascular Health Study) measured at bas ...[more]

PMID: 21226680

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Project description:IntroductionHyperkyphosis commonly affects older people but is not widely acknowledged as a clinically actionable problem, especially in men. There are several techniques to quantify kyphosis including the blocks and Cobb angle measurements. This study includes both kyphosis measures to investigate whether older men with accentuated kyphosis may be at increased mortality risk.MethodsMen aged ≥65 years (N = 5994) were recruited to participate in the MrOS prospective cohort study from 2000 to 2002 (baseline). Our primary cohort included 2931 enrollees (mean age 79.3 years; SD 5.2) who underwent blocks-measured kyphosis from 2006 to 2009. Our secondary cohort included 2351 participants who underwent radiographic Cobb angle measurements at baseline. Cox proportional hazards analyses were used to determine association between kyphosis and all-cause mortality while adjusting for prevalent radiographic vertebral fractures, bone mineral density, incident fractures, gait speed, timed chair stands, self-reported health, alcohol use, medical co-morbidities, and physical activity.ResultsDuring a mean follow-up of 8.3 (SD 3.2) years, 1393 participants died in the primary cohort. In this group, compared to men with 0-1 block kyphosis, increasing blocks-measured kyphosis was associated with increased mortality (HR: 1.26-1.53, p trend <0.001). With addition of prevalent vertebral fracture to adjusted models, the association remained significant in participants with severe kyphosis (3+ blocks-measured). Similarly, with addition of chair stand performance the association remained significant for 4+ blocks kyphosis. Walking speed did not attenuate the association of kyphosis and mortality. In the secondary cohort, there were no significant associations between radiographic Cobb angle kyphosis and mortality.ConclusionsIncreasing blocks-measured kyphosis was associated with a greater risk of mortality in older men, indicating that hyperkyphosis identified on physical exam should be considered a clinically significant finding that may warrant further evaluation and treatment.

Dataset Information

Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study.

Publications

Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study.

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