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Submitted on July 13, 2006
Accepted on February 28, 2007
EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands; Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands; Department of General Practice, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; Department of Sociology and Social Gerontology, VU University, Amsterdam, The Netherlands; Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands; Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
* To whom correspondence should be addressed. 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: To investigate the association of serum 25-hydroxyvitamin D (25-OHD) concentration with current physical performance and its decline over 3 years among elderly.
Design: Cross-sectional and longitudinal design (3 years follow-up) within the Longitudinal Aging Study Amsterdam.
Setting: An age- and sex-stratified random sample of the Dutch older population.
Other participants: Subjects included 1234 men and women (aged 65yr 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.
Results: serum 25-OHD was associated with physical performance after adjustment for age, gender, chronic diseases, degree of urbanization, BMI, and alcohol consumption. Compared with individuals with serum 25-OHD levels above 30ng/ml, physical performance was poorer in participants with serum 25-OHD<10ng/ml (B= -1.69; 95% confidence interval[CI]= -2.28; -1.10), and with serum 25-OHD 10-20ng/ml (B= -0.46; 95%CI=-0.90;-0.03). After adjustment for confounding variables, participants with 25-OHD<10ng/ml and 25-OHD 10-20ng/ml had significantly higher odds ratios (OR) for 3-year 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
30ng/ml. The results were consistent for each individual performance test.
Conclusions: Serum 25-OHD concentrations <20ng/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<20ng/ml, public health strategies should be aimed at this group.
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