Vitamin D and Physical Performance in Elderly Subjects: The Pro.V.A Study

Elena D Toffanello,Leonardo Sartori,Giuseppe Sergi,Estella Musacchio,Alessandra Coin,Sabina Zambon,Giovannella Baggio,Gaetano Crepaldi,Maria-Chiara Corti,Egle Perissinotto,Stefania Maggi,Enzo Manzato

doi:10.1371/journal.pone.0034950

Elena D Toffanello, Leonardo Sartori + Show 10 more

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https://doi.org/10.1371/journal.pone.0034950

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Abstract

BackgroundThe role of Vitamin D in musculoskeletal functionality among elderly people is still controversial. We investigated the association between serum 25-hydroxyvitamin D (25OHD) levels and physical performance in older adults.Methods2694 community-dwelling elderly women and men from the Progetto Veneto Anziani (Pro.V.A.) were included. Physical performances were assessed by: tandem test, 5 timed chair stands (TCS), gait speed, 6-minute walking (6 mW) distance, handgrip strength, and quadriceps strength. For each test, separate general linear models and loess plots were obtained in both genders, in relation to serum 25OHD concentrations, controlling for several potential confounders.ResultsLinear associations with 25OHD levels were observed for TCS, gait speed, 6 mW test and handgrip strength, but not for tandem test and quadriceps strength. After adjusting for potential confounders, linear associations with 25OHD levels were still evident for the 6 mW distance in both genders (p = .0002 in women; <.0001 in men), for TCS in women (p = .004) and for gait speed (p = .0006) and handgrip strength (p = .03) in men. In loess analyses, performance in TCS in women, in gait speed and handgrip strength in men and in 6 mW in both genders, improved with increasing levels of 25OHD, with most of the improvements occurring for 25OHD levels from 20 to 100 nmol/L.Conclusionlower 25OHD levels are associated with a worse coordination and weaker strength (TCS) in women, a slower walking time and a lower upper limb strength in men, and a weaker aerobic capacity (6 mW) in both genders. For optimal physical performances, 25OHD concentrations of 100 nmol/L appear to be more advantageous in elderly men and women, and Vitamin D supplementation should be encouraged to maintain their 25OHD levels as high as this threshold.

Highlights

Aging people develop mobility impairment as a first step in the disablement process [1]
Population-based sample of community-dwelling Italian elderly subjects, we found a significant positive association between 25OHD concentrations and 4 of the 6 performance tests habitually used to assess mobility impairment
The association was strong for timed chair stands (TCS), gait speed, 6-minute walking (6 mW) distance and handgrip strength

Summary

Introduction

Aging people develop mobility impairment as a first step in the disablement process [1]. Most of the studies supporting the association between vitamin D and physical performance limited their analysis to two or three tests, such as chair stands or gait tests [10,11,16,17,18,19], which are not representative of global muscle function. Another bias concerns the application of vitamin D cut-offs usually established to define the risk for osteoporosis, which are not expected to define mobility risk [10,20]. We investigated the association between serum 25-hydroxyvitamin D (25OHD) levels and physical performance in older adults

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