Abstract
Background: The association between circulating levels of vitamin D and the incidence of chronic diseases is known. The identification of vitamin D as a biomarker of physiological/pathological ageing could contribute to expanding current knowledge of its involvement in healthy ageing. Methods: According to PRISMA guidelines, a systematic review was conducted on cohorts studying the role of 25OH-Vitamin D [25(OH)D] and 1,25(OH)2-Vitamin D [1,25(OH)2D] concentrations as biomarkers of healthy ageing. We consulted MedLine, Scopus, and Web of Science to search for studies on the association between vitamin D status in populations of originally healthy adults, and outcomes of longevity, illness, and physical and cognitive functionality. The quality of the studies was assessed using the Newcastle Ottawa scale. Results: Twenty cohorts from 24 articles were selected for this review. Inverse associations were found between low 25(OH)D levels and all-cause mortality, respiratory and cardiovascular events, as well as markers relating to hip and non-vertebral fractures. Associations between 1,25(OH)2D and healthy ageing outcomes gave similar results, although of lower clinical significance. Conclusions: This systematic review pinpoints peculiar aspects of vitamin D as a multidimensional predictor of ill health in the ageing process. Further well-designed controlled trials to investigate whether vitamin D supplement results in superior outcomes are warranted in the future.
Highlights
The promotion of healthy ageing is an essential objective in the strategy of making public health sustainable
Articles were excluded if data on baseline health status of the cohort were missing; Exposure: populations analyzed according to baseline levels of 25(OH)D or 1,25(OH)2 D; Controls: control groups enrolled from the same population of exposed people or as cases; Outcomes: indicators of the ten dimensions of the healthy ageing concept [31,32]; Studies: the analysis included cohort studies, panel studies, and nested case-control in cohorts reporting analyses of associations between vitamin D measured at baseline and at least one outcome measured at follow-up, or analyses of validity/reliability of biomarker/s for the prediction of healthy ageing outcomes at follow-up by means of Receiver operating characteristic (ROC)
In 4 other articles vitamin D was not the exposure factor analyzed, outcomes used for the purpose of this
Summary
The promotion of healthy ageing is an essential objective in the strategy of making public health sustainable. Health is not the only dimension of successful ageing, the reduction of the incidence and prevalence of diseases among older people can be considered to be one of the most relevant involved factors. For this purpose, the identification of biomarkers of healthy or successful ageing is an essential goal, to early detect unfavorable conditions and promote personalized prevention and treatment programs. The identification of vitamin D as a biomarker of physiological/pathological ageing could contribute to expanding current knowledge of its involvement in healthy ageing
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