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Vitamin D Status Predicts Physical Performance and Its Decline in Older Persons

EMGO Institute (I.S.W., N.M.v.S., A.J.P.B., M.V., D.J.H.D., P.L.), VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Departments of Endocrinology (P.L.), Psychiatry (D.J.H.D., J.S.), and Clinical Epidemiology and Biostatistics (D.L.K.), VU University Medical Center, Postbus 7057–1007 MB Amsterdam, The Netherlands; and Institute of Health Sciences, Faculty of Earth and Life Sciences (I.S.W., M.V.), and Department of Sociology and Social Gerontology (J.S.), VU University, 1081 HV Amsterdam, The Netherlands

Address all correspondence and requests for reprints to: Paul Lips, M.D., Ph.D., Department of Endocrinology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: P.Lips{at}vumc.nl.

Context: Vitamin D deficiency is common among older people and can cause mineralization defects, bone loss, and muscle weakness.

Objective: The aim of this study was to investigate the association of serum 25-hydroxyvitamin D (25-OHD) concentration with current physical performance and its decline over 3 yr among elderly.

Design: The study consisted of a cross-sectional and longitudinal design (3-yr follow-up) within the Longitudinal Aging Study Amsterdam.

Setting: An age- and sex-stratified random sample of the Dutch older population was used.

Other Participants: Subjects included 1234 men and women (aged 65 yr and older) for cross-sectional analysis and 979 (79%) persons for longitudinal analysis.

Main Outcome Measure(s): Physical performance (sum score of the walking test, chair stands, and tandem stand) and decline in physical performance were measured.

Results: Serum 25-OHD was associated with physical performance after adjustment for age, gender, chronic diseases, degree of urbanization, body mass index, and alcohol consumption. Compared with individuals with serum 25-OHD levels above 30 ng/ml, physical performance was poorer in participants with serum 25-OHD less than 10 ng/ml [regression coefficient (B) = –1.69; 95% confidence interval (CI) = –2.28; –1.10], and with serum 25-OHD of 10–20 ng/ml (B = –0.46; 95% CI = –0.90; –0.03). After adjustment for confounding variables, participants with 25-OHD less than 10 ng/ml and 25-OHD between 10 and 20 ng/ml had significantly higher odds ratios (OR) for 3-yr decline in physical performance (OR = 2.21; 95% CI = 1.00–4.87; and OR = 2.01; 95% CI = 1.06–3.81), compared with participants with 25-OHD of at least 30 ng/ml. The results were consistent for each individual performance test.

Conclusions: Serum 25-OHD concentrations below 20 ng/ml are associated with poorer physical performance and a greater decline in physical performance in older men and women. Because almost 50% of the population had serum 25-OHD below 20 ng/ml, public health strategies should be aimed at this group.

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