Journal Article

Low Vitamin D Levels and Frailty Status in Older Adults: A Systematic Review and Meta-Analysis

Proietti, Stefania, Marcos-Pérez, Diego, Fernández-Tajes, Juan, Laffon, Blanca, Costa, Solange, Pásaro, Eduardo, Sánchez-Flores, María, Teixeira, Joao Paulo, Bonassi, Stefano, Valdiglesias, Vanessa

2020

Overview

Serum vitamin D deficiency is widespread among older adults and is a potential modifiable risk factor for frailty. Moreover, frailty has been suggested as an intermediate step in the association between low levels of vitamin D and mortality. Hence, we conducted a systematic review of the literature and meta-analysis to test the possible association of low concentrations of serum 25-hydroxyvitamin D (25(OH)D), a marker of vitamin D status, with frailty in later life. We reviewed cross-sectional or longitudinal studies evaluating populations of older adults and identifying frailty by a currently validated scale. Meta-analyses were restricted to cross-sectional data from studies using Fried’s phenotype to identify frailty. Twenty-six studies were considered in the qualitative synthesis, and thirteen studies were included in the meta-analyses. Quantitative analyses showed significant differences in the comparisons of frail (standardized mean difference (SMD)—1.31, 95% confidence interval (CI) (−2.47, −0.15), p = 0.0271) and pre-frail (SMD—0.79, 95% CI (−1.58, −0.003), p = 0.0491) subjects vs. non-frail subjects. Sensitivity analyses reduced heterogeneity, resulting in a smaller but still highly significant between-groups difference. Results obtained indicate that lower 25(OH)D levels are significantly associated with increasing frailty severity. Future challenges include interventional studies testing the possible benefits of vitamin D supplementation in older adults to prevent/palliate frailty and its associated outcomes.

• Publisher: MDPI AG,MDPI
• Subject: Aged / Aged, 80 and over / blood serum / confidence interval / Cross-Sectional Studies / Diabetes / Elder Nutritional Physiological Phenomena / Female / Frail Elderly / Frailty / Frailty - blood / Frailty - complications / Health Sciences / Humans / Hälsovetenskap / Identification / literature / Longitudinal Studies / Male / Medical and Health Sciences / Medicin och hälsovetenskap / Meta-analysis / Mortality / Nutrition and Dietetics / Nutritional Status / Näringslära och dietkunskap / Older people / phenotype / Population / Review / Risk Factors / synthesis / Systematic review / Vitamin D / Vitamin D - analogs & derivatives / Vitamin D - blood / Vitamin D Deficiency - complications / Vitamin deficiency