Dawn E Alley

Publication Detail

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Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: the Invecchiare in Chianti Study.

Michelle Shardell; Christopher D'Adamo; Dawn E Alley; Ram R Miller; Gregory E Hicks; Yuri Milaneschi; Richard D Semba; Antonio Cherubini; Stefania Bandinelli; Luigi Ferrucci (Profiled Authors: Dawn E Alley; Michelle D Shardell; Christopher D'Adamo; Ram R Miller)

Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA. mshardel@epi.umaryland.edu
Journal of the American Geriatrics Society 2012;60(2):256-64.

OBJECTIVES: To assess whether serum 25-hydroxyvitamin D (25(OH)D) concentrations relate to transitions between the states of robustness, prefrailty, and frailty and to mortality in older adults. DESIGN: The Invecchiare in Chianti (InCHIANTI) Study, a prospective cohort study. SETTING: Tuscany, Italy. PARTICIPANTS: Adults aged 65 and older (N = 1,155). MEASUREMENTS: Serum 25(OH)D concentrations measured at baseline; frailty state (robust, prefrail, frail) assessed at baseline and 3 and 6 years after enrollment; and vital status determined 3 and 6 years after enrollment. RESULTS: The median (interquartile range) 25(OH)D concentration was 16.0 ng/mL (10.4-25.6 ng/mL; multiply by 2.496 to convert to nmol/L). Prefrail participants with 25(OH)D levels less than 20 ng/mL were 8.9% (95% confidence interval (CI) = 2.5-15.2%) more likely to die, 3.0% (95% CI = -5.6-14.6%) more likely to become frail, and 7.7% (95% CI = -3.5-18.7%) less likely to become robust than prefrail participants with 25(OH)D levels of 20 ng/mL or more. In prefrail participants, each 5-ng/mL decrement of continuous 25(OH)D was associated with 1.46 times higher odds of dying (95% CI = 1.18-2.07) and 1.13 higher odds of incident frailty (95% CI = 0.90-1.39) than with recovery of robustness. Transitions from robustness or frailty were not associated with 25(OH)D levels. CONCLUSION: Results provide evidence that prefrailty is an "at risk" state from which older adults with high 25(OH)D levels are more likely to recover than to decline, but high 25(OH)D levels were not associated with recovery from frailty. Thus, 25(OH)D levels should be investigated as a potential therapy to treat prefrailty and prevent further decline.

3 Originating Grant

• 1.

  SHARDELL, MICHELLE DENISE

  Statistical Methods to Correct for Proxy Bias in Studies of Older Adults

  1 April 2011 - 31 March 2014

  NATIONAL INSTITUTE ON AGING

• 2.

  MILLER, RAM R

  Consequences of Inflammation on Muscle Following Hip Fracture

  1 May 2008 - 30 April 2013

  NATIONAL INSTITUTE ON AGING

• 3.

  MAGAZINER, JAY

  Research Training in the Epidemiology of Aging

  1 May 1998 - 30 April 2013

  NATIONAL INSTITUTE ON AGING

Scientific Context

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