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Vitamin D status is associated with physical performance: the results of three independent cohorts

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Abstract

Summary

This study, on the association between vitamin D status and physical performance and its decline, shows that vitamin D status is associated with physical performance in several older age groups. However, vitamin D status does not predict a decline in physical performance in individuals aged 55–65 years.

Introduction

Previous research in the Longitudinal Aging Study Amsterdam (LASA) showed an association of vitamin D status with physical performance and its decline in persons aged 65 years and older. The current study aims to determine these associations in younger individuals and to replicate previous research of LASA.

Methods

Data from three independent cohorts were used: two cohorts of LASA (LASA-II with measurements in 2002 (n = 707) and 2009 (n = 491), LASA-I-2009 (n = 355)) and the baseline measurement of the B-Vitamins for the Prevention of Osteoporotic Fractures (B-PROOF) study (n = 2,813). Participants performed three tests (walking test, chair stands, and tandem stand; range total score 0–12), except in LASA-II-2002 (only walking and chair stands tests; range total score 0–8). Multiple linear and logistic regression were used to assess whether vitamin D status was associated with total physical performance and its decline, respectively.

Results

The mean age of the participants was 60.0 (SD 3.0), 65.9 (2.9), 78.4 (5.3), and 74.4 (6.8) years for LASA-II-2002, LASA-II-2009, LASA-I-2009, and B-PROOF, respectively. Vitamin D status was not predictive of a clinical decline in total physical performance score in the LASA-II-2002 cohort (aged 55–65 years). After adjustment for confounding, participants with serum 25(OH)D < 50 nmol/L scored 0.8 (95 % confidence interval 0.4–1.2), 0.9 (0.3–1.5), 1.5 (0.8–2.3), and 0.6 (0.3–0.9) points lower on total physical performance than participants with serum 25(OH)D ≥ 75 nmol/L.

Conclusion

Our study confirmed that serum 25(OH)D is associated with physical performance. However, vitamin D status did not predict a clinical decline in physical performance in individuals aged 55–65 years.

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References

  1. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501

    Article  PubMed  CAS  Google Scholar 

  2. Heijboer AC, Blankenstein MA, Kema IP, Buijs MM (2012) Accuracy of 6 routine 25-hydroxyvitamin D assays: influence of vitamin D binding protein concentration. Clin Chem 58:543–548

    Article  PubMed  CAS  Google Scholar 

  3. Bischoff-Ferrari H (2010) Health effects of vitamin D. Dermatol Ther 23:23–30

    Article  PubMed  Google Scholar 

  4. Allali F, El Aichaoui S, Khazani H, Benyahia B, Saoud B, El Kabbaj S, Bahiri R, Abouqal R, Hajjaj-Hassouni N (2009) High prevalence of hypovitaminosis D in Morocco: relationship to lifestyle, physical performance, bone markers, and bone mineral density. Semin Arthritis Rheum 38:444–451

    Article  PubMed  CAS  Google Scholar 

  5. Ceglia L, Chiu GR, Harris SS, Araujo AB (2011) Serum 25-hydroxyvitamin D concentration and physical function in adult men. Clin Endocrinol (Oxf) 74:370–376

    Article  CAS  Google Scholar 

  6. Dhesi JK, Bearne LM, Moniz C, Hurley MV, Jackson SHD, Swift CG, Allain TJ (2002) Neuromuscular and psychomotor function in elderly subjects who fall and the relationship with vitamin D status. J Bone Miner Res 17:891–897

    Article  PubMed  CAS  Google Scholar 

  7. Gerdhem P, Ringsberg KAM, Obrant KJ, Akesson K (2005) Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. Osteoporos Int 16:1425–1431

    Article  PubMed  CAS  Google Scholar 

  8. Houston DK, Tooze JA, Hausman DB, Johnson MA, Nicklas BJ, Miller ME, Neiberg RH, Marsh AP, Newman AB, Blair SN, Kritchevsky SB (2011) Change in 25-hydroxyvitamin D and physical performance in older adults. J Gerontol A Biol Sci Med Sci 66:430–436

    Article  PubMed  Google Scholar 

  9. Kenny AM, Biskup B, Robbins B, Marcella G, Burleson JA (2003) Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men. J Am Geriatr Soc 51:1762–1767

    Article  PubMed  Google Scholar 

  10. Scott D, Blizzard L, Fell J, Ding C, Winzenberg T, Jones G (2010) A prospective study of the associations between 25-hydroxy-vitamin D, sarcopenia progression and physical activity in older adults. Clin Endocrinol (Oxf) 73:581–587

    Article  CAS  Google Scholar 

  11. Verreault R, Semba RD, Volpato S, Ferrucci L, Fried LP, Guralnik JM (2002) Low serum vitamin d does not predict new disability or loss of muscle strength in older women. J Am Geriatr Soc 50:912–917

    Article  PubMed  Google Scholar 

  12. Wicherts IS, van Schoor NM, Boeke AJ, Visser M, Deeg DJH, Smit J, Knol DL, Lips P (2007) Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab 92:2058–2065

    Article  PubMed  CAS  Google Scholar 

  13. Zamboni M, Zoico E, Tosoni P, Zivelonghi A, Bortolani A, Maggi S, Di Francesco V, Bosello O (2002) Relation between vitamin D, physical performance, and disability in elderly persons. J Gerontol A Biol Sci Med Sci 57:M7–M11

    Article  PubMed  Google Scholar 

  14. Deeg DJH, van Tilburg T, Smit JH, de Leeuw ED (2002) Attrition in the longitudinal aging study Amsterdam. The effect of differential inclusion in side studies. J Clin Epidemiol 55:319–328

    Article  PubMed  Google Scholar 

  15. Huisman M, Poppelaars J, van der Horst M, Beekman ATF, Brug J, van Tilburg TG, Deeg DJH (2011) Cohort profile: the longitudinal aging study Amsterdam. Int J Epidemiol 40:868–876

    Article  PubMed  Google Scholar 

  16. van Wijngaarden J, Dhonukshe-Rutten R, van Schoor N, van der Velde N, Swart K, Enneman A, van Dijk S, Brouwer-Brolsma E, Zillikens M, van Meurs J, Brug J, Uitterlinden A, Lips P, de Groot L (2011) Rationale and design of the B-PROOF study, a randomized controlled trial on the effect of supplemental intake of vitamin B12 and folic acid on fracture incidence. BMC Geriatr 11:80

    Article  PubMed  Google Scholar 

  17. Speer DC (1992) Clinically significant change: Jacobson and Truax (1991) revisited. J Consult Clin Psychol 60:402–408

    Article  PubMed  CAS  Google Scholar 

  18. Speer DC, Greenbaum PE (1995) Five methods for computing significant individual client change and improvement rates: support for an individual growth curve approach. J Consult Clin Psychol 63:1044–1048

    Article  PubMed  CAS  Google Scholar 

  19. Visser M, Pluijm SMF, Stel VS, Bosscher RJ, Deeg DJH (2002) Physical activity as a determinant of change in mobility performance: the longitudinal aging study Amsterdam. J Am Geriatr Soc 50:1774–1781

    Article  PubMed  Google Scholar 

  20. Den Dulk CJ, Van De Stadt H, Vliegen JM (1992) Een nieuwe maatstaaf voor stedelijkheid: de omgevingsadressendichtheid (A new measure for degree of urbanization: the address density of the surrounding area). Maandstat Bevolking 40:14–27

    Google Scholar 

  21. Garretsen HFL (1983) Probleemdrinken, prevalentiebepaling, beinvloedende factoren en preventiemogelijkheden, Theoretische overwegingen en onderzoek in Rotterdam (dissertation in Dutch).

  22. Stel VS, Smit JH, Pluijm SMF, Visser M, Deeg DJH, Lips P (2004) Comparison of the LASA physical activity questionnaire with a 7-day diary and pedometer. J Clin Epidemiol 57:252–258

    Article  PubMed  Google Scholar 

  23. IOM (Institute of Medicine) (2011) Dietary reference intakes for calcium and vitamin D. The National Academies Press, Washington

    Google Scholar 

  24. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930

    Article  PubMed  CAS  Google Scholar 

  25. Steenland K, Deddens JA (2004) A practical guide to dose–response analyses and risk assessment in occupational epidemiology. Epidemiology 15:63–70

    Article  PubMed  Google Scholar 

  26. Dam T-TL, von Muhlen D, Barrett-Connor EL (2009) Sex-specific association of serum vitamin D levels with physical function in older adults. Osteoporos Int 20:751–760

    Article  PubMed  CAS  Google Scholar 

  27. Bartali B, Frongillo EA, Guralnik JM, Stipanuk MH, Allore HG, Cherubini A, Bandinelli S, Ferrucci L, Gill TM (2008) Serum micronutrient concentrations and decline in physical function among older persons. JAMA 299:308–315

    Article  PubMed  CAS  Google Scholar 

  28. Faulkner KA, Cauley JA, Zmuda JM, Landsittel DP, Newman AB, Studenski SA, Redfern MS, Ensrud KE, Fink HA, Lane NE, Nevitt MC (2006) Higher 1,25-dihydroxyvitamin D3 concentrations associated with lower fall rates in older community-dwelling women. Osteoporos Int 17:1318–1328

    Article  PubMed  CAS  Google Scholar 

  29. Cawthon PM, Fullman RL, Marshall L, Mackey DC, Fink HA, Cauley JA, Cummings SR, Orwoll ES, Ensrud KE (2008) Physical performance and risk of hip fractures in older men. J Bone Miner Res 23:1037–1044

    Article  PubMed  Google Scholar 

  30. Corsonello A, Lattanzio F, Pedone C, Garasto S, Laino I, Bustacchini S, Pranno L, Mazzei B, Passarino G, Incalzi, On behalf of the PharmacosurVeillance in the elderly Care (PVC) Study (2012) Prognostic significance of the short physical performance battery in older patients discharged from acute care hospitals. Rejuvenation Res 15:41–48

    Article  PubMed  Google Scholar 

  31. Gill TM (2010) Assessment of function and disability in longitudinal studies. J Am Geriatr Soc 58(Suppl 2):S308–S312

    Article  PubMed  Google Scholar 

  32. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:M85–M94

    Article  PubMed  CAS  Google Scholar 

  33. Bischoff-Ferrari HA (2012) Relevance of vitamin D in muscle health. Rev Endocr Metab Disord 13:71–77

    Article  PubMed  CAS  Google Scholar 

  34. Annweiler C, Schott AM, Berrut G, Fantino B, Beauchet O (2009) Vitamin D-related changes in physical performance: a systematic review. J Nutr Health Aging 13:893–898

    Article  PubMed  CAS  Google Scholar 

  35. Latham NK, Anderson CS, Reid IR (2003) Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review. J Am Geriatr Soc 51:1219–1226

    Article  PubMed  Google Scholar 

  36. Muir SW, Montero-Odasso M (2011) Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 59:2291–2300

    Article  PubMed  Google Scholar 

  37. Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822

    Article  PubMed  CAS  Google Scholar 

  38. Kwon S, Perera S, Pahor M, Katula JA, King AC, Groessl EJ, Studenski SA (2009) What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study). J Nutr Health Aging 13:538–544

    Article  PubMed  CAS  Google Scholar 

  39. Perera S, Mody SH, Woodman RC, Studenski SA (2006) Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 54:743–749

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was partly funded by ZonMw (the Netherlands Organization for Health Research and Development). LASA is largely supported by a grant from the Netherlands Ministry of Health, Welfare, and Sports, Directorate of Long-Term Care. The B-PROOF study is funded by ZonMw, NZO (Dutch Dairy Association), Orthica, NCHA (Netherlands Consortium Healthy Ageing), and Ministry of Economic Affairs, Agriculture, and Innovation. The serum 25(OH)D measurements in LASA were partly funded by Merck & Co. We would like to thank the research team and participants of LASA and B-PROOF.

Conflicts of interest

An unconditional grant was received from Merck & Co. for part of the 25-hydroxyvitamin D measurements. All authors have nothing to disclose.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

    E. Sohl, K. M. A. Swart & N. M. van Schoor

  2. Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam, The Netherlands

    R. T. de Jongh & P. Lips

  3. Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands

    A. C. Heijboer

  4. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    E. M. Brouwer-Brolsma, C. P. G. M. de Groot & R. A. M. Dhonukshe-Rutten

  5. Department of Internal Medicine-Section Geriatric Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands

    A. W. Enneman & N. van der Velde

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  1. E. Sohl
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  2. R. T. de Jongh
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  3. A. C. Heijboer
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  7. C. P. G. M. de Groot
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  8. N. van der Velde
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  9. R. A. M. Dhonukshe-Rutten
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  10. P. Lips
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  11. N. M. van Schoor
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Corresponding author

Correspondence to N. M. van Schoor.

Additional information

Clinical trial registration number for B-PROOF: Netherlands trial: NTR 1333, ClinicalTrials.gov: NCT00696514.

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Sohl, E., de Jongh, R.T., Heijboer, A.C. et al. Vitamin D status is associated with physical performance: the results of three independent cohorts. Osteoporos Int 24, 187–196 (2013). https://doi.org/10.1007/s00198-012-2124-5

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  • DOI: https://doi.org/10.1007/s00198-012-2124-5

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