The effects of vitamin D supplementation on frailty in older adults at risk for falls
Abstract Background Low serum 25-hydroxyvitamin D [25(OH)D] level is associated with a greater risk of frailty, but the effects of daily vitamin D supplementation on frailty are uncertain. This secondary analysis aimed to examine the effects of vitamin D supplementation on frailty using data from th...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-02888-w |
| _version_ | 1819210259414122496 |
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| author | Yurun Cai Amal A. Wanigatunga Christine M. Mitchell Jacek K. Urbanek Edgar R. Miller Stephen P. Juraschek Erin D. Michos Rita R. Kalyani David L. Roth Lawrence J. Appel Jennifer A. Schrack |
| author_facet | Yurun Cai Amal A. Wanigatunga Christine M. Mitchell Jacek K. Urbanek Edgar R. Miller Stephen P. Juraschek Erin D. Michos Rita R. Kalyani David L. Roth Lawrence J. Appel Jennifer A. Schrack |
| author_sort | Yurun Cai |
| collection | DOAJ |
| description | Abstract Background Low serum 25-hydroxyvitamin D [25(OH)D] level is associated with a greater risk of frailty, but the effects of daily vitamin D supplementation on frailty are uncertain. This secondary analysis aimed to examine the effects of vitamin D supplementation on frailty using data from the Study To Understand Fall Reduction and Vitamin D in You (STURDY). Methods The STURDY trial, a two-stage Bayesian, response-adaptive, randomized controlled trial, enrolled 688 community-dwelling adults aged ≥ 70 years with a low serum 25(OH)D level (10–29 ng/mL) and elevated fall risk. Participants were initially randomized to 200 IU/d (control dose; n = 339) or a higher dose (1000 IU/d, 2000 IU/d, or 4000 IU/d; n = 349) of vitamin D3. Once the 1000 IU/d was selected as the best higher dose, other higher dose groups were reassigned to the 1000 IU/d group and new enrollees were randomized 1:1 to 1000 IU/d or control group. Data were collected at baseline, 3, 12, and 24 months. Frailty phenotype was based on number of the following conditions: unintentional weight loss, exhaustion, slowness, low activity, and weakness (≥ 3 conditions as frail, 1 or 2 as pre-frail, and 0 as robust). Cox proportional hazard models estimated the risk of developing frailty, or improving or worsening frailty status at follow-up. All models were adjusted for demographics, health conditions, and further stratified by baseline serum 25(OH)D level (insufficiency (20–29 ng/mL) vs. deficiency (10–19 ng/mL)). Results Among 687 participants (mean age 77.1 ± 5.4, 44% women) with frailty assessment at baseline, 208 (30%) were robust, 402 (59%) were pre-frail, and 77 (11%) were frail. Overall, there was no significant difference in risk of frailty outcomes comparing the pooled higher doses (PHD; ≥ 1000 IU/d) vs. 200 IU/d. When comparing each higher dose vs. 200 IU/d, the 2000 IU/d group had nearly double the risk of worsening frailty status (HR = 1.89, 95% CI: 1.13–3.16), while the 4000 IU/d group had a lower risk of developing frailty (HR = 0.22, 95% CI: 0.05–0.97). There were no significant associations between vitamin D doses and frailty status in the analyses stratified by baseline serum 25(OH)D level. Conclusions High dose vitamin D supplementation did not prevent frailty. Significant subgroup findings might be the results of type 1 error. Trial registration ClinicalTrials.gov: NCT02166333 . |
| first_indexed | 2024-12-23T06:08:20Z |
| format | Article |
| id | doaj.art-70e17acfca034c9e9940213c09e3af31 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-23T06:08:20Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-70e17acfca034c9e9940213c09e3af312022-12-21T17:57:32ZengBMCBMC Geriatrics1471-23182022-04-012211910.1186/s12877-022-02888-wThe effects of vitamin D supplementation on frailty in older adults at risk for fallsYurun Cai0Amal A. Wanigatunga1Christine M. Mitchell2Jacek K. Urbanek3Edgar R. Miller4Stephen P. Juraschek5Erin D. Michos6Rita R. Kalyani7David L. Roth8Lawrence J. Appel9Jennifer A. Schrack10Department of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthCenter On Aging and Health, Johns Hopkins UniversityWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical InstitutionsDivision of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical SchoolWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical InstitutionsCenter On Aging and Health, Johns Hopkins UniversityCenter On Aging and Health, Johns Hopkins UniversityDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthAbstract Background Low serum 25-hydroxyvitamin D [25(OH)D] level is associated with a greater risk of frailty, but the effects of daily vitamin D supplementation on frailty are uncertain. This secondary analysis aimed to examine the effects of vitamin D supplementation on frailty using data from the Study To Understand Fall Reduction and Vitamin D in You (STURDY). Methods The STURDY trial, a two-stage Bayesian, response-adaptive, randomized controlled trial, enrolled 688 community-dwelling adults aged ≥ 70 years with a low serum 25(OH)D level (10–29 ng/mL) and elevated fall risk. Participants were initially randomized to 200 IU/d (control dose; n = 339) or a higher dose (1000 IU/d, 2000 IU/d, or 4000 IU/d; n = 349) of vitamin D3. Once the 1000 IU/d was selected as the best higher dose, other higher dose groups were reassigned to the 1000 IU/d group and new enrollees were randomized 1:1 to 1000 IU/d or control group. Data were collected at baseline, 3, 12, and 24 months. Frailty phenotype was based on number of the following conditions: unintentional weight loss, exhaustion, slowness, low activity, and weakness (≥ 3 conditions as frail, 1 or 2 as pre-frail, and 0 as robust). Cox proportional hazard models estimated the risk of developing frailty, or improving or worsening frailty status at follow-up. All models were adjusted for demographics, health conditions, and further stratified by baseline serum 25(OH)D level (insufficiency (20–29 ng/mL) vs. deficiency (10–19 ng/mL)). Results Among 687 participants (mean age 77.1 ± 5.4, 44% women) with frailty assessment at baseline, 208 (30%) were robust, 402 (59%) were pre-frail, and 77 (11%) were frail. Overall, there was no significant difference in risk of frailty outcomes comparing the pooled higher doses (PHD; ≥ 1000 IU/d) vs. 200 IU/d. When comparing each higher dose vs. 200 IU/d, the 2000 IU/d group had nearly double the risk of worsening frailty status (HR = 1.89, 95% CI: 1.13–3.16), while the 4000 IU/d group had a lower risk of developing frailty (HR = 0.22, 95% CI: 0.05–0.97). There were no significant associations between vitamin D doses and frailty status in the analyses stratified by baseline serum 25(OH)D level. Conclusions High dose vitamin D supplementation did not prevent frailty. Significant subgroup findings might be the results of type 1 error. Trial registration ClinicalTrials.gov: NCT02166333 .https://doi.org/10.1186/s12877-022-02888-wFrailtyNutrition supplementationVitamin D3Randomized controlled trial |
| spellingShingle | Yurun Cai Amal A. Wanigatunga Christine M. Mitchell Jacek K. Urbanek Edgar R. Miller Stephen P. Juraschek Erin D. Michos Rita R. Kalyani David L. Roth Lawrence J. Appel Jennifer A. Schrack The effects of vitamin D supplementation on frailty in older adults at risk for falls BMC Geriatrics Frailty Nutrition supplementation Vitamin D3 Randomized controlled trial |
| title | The effects of vitamin D supplementation on frailty in older adults at risk for falls |
| title_full | The effects of vitamin D supplementation on frailty in older adults at risk for falls |
| title_fullStr | The effects of vitamin D supplementation on frailty in older adults at risk for falls |
| title_full_unstemmed | The effects of vitamin D supplementation on frailty in older adults at risk for falls |
| title_short | The effects of vitamin D supplementation on frailty in older adults at risk for falls |
| title_sort | effects of vitamin d supplementation on frailty in older adults at risk for falls |
| topic | Frailty Nutrition supplementation Vitamin D3 Randomized controlled trial |
| url | https://doi.org/10.1186/s12877-022-02888-w |
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