Circulating 25-Hydroxyvitamin D Levels and Frailty Status in Older Women

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Abstract
Context: Vitamin D deficiency and frailty are common with aging, but the association between these conditions is uncertain. Objective: To determine the association between 25-hydroxyvitamin D (25(OH)D) levels and prevalent and incident frailty status among older women. Design: Cross-sectional and longitudinal analyses of a prospective cohort study. Setting: Four U.S. centers. Participants: 6307 women aged ≥69 years. Main Outcome Measures: Frailty status classified as robust, intermediate stage, or frail at baseline; and robust, intermediate stage, frail, or dead (all-cause mortality) at follow-up an average of 4.5 years later. Results: At baseline, there was a U-shaped association between 25(OH)D level and odds of frailty with the lowest risk among women with levels 20.0–29.9 ng/ml (referent group). Compared with this group, the odds of frailty were higher among those with levels vs. robust/intermediate) at follow-up appeared higher among those with levels 15.0–19.9 ng/ml (MOR 1.21, 95% CI 0.99–1.49), but the CI overlapped 1.0. The odds of death (vs. robust/intermediate/frail at follow-up) was higher among those with levels Conclusion: Lower (<20 ng/ml) and higher (≥30 ng/ml) levels of 25(OH)D among older women were moderately associated with a higher odds of frailty at baseline. Among nonfrail women at baseline, lower levels (<20 ng/ml) were modestly associated with an increased risk of incident frailty or death at follow-up.