Combined Effect of Dynapenia (Muscle Weakness) and Low Vitamin D Status on Incident Disability

Flávia Silva Arbex Borim; Tiago da Silva Alexandre; Anita Liberalesso Neri; Roberta de Oliveira Máximo; Marcela Fernandes Silva; Cesar de Oliveira

doi:10.1016/j.jamda.2018.06.006

Combined Effect of Dynapenia (Muscle Weakness) and Low Vitamin D Status on Incident Disability

J Am Med Dir Assoc. 2019 Jan;20(1):47-52. doi: 10.1016/j.jamda.2018.06.006. Epub 2018 Aug 1.

Authors

Flávia Silva Arbex Borim¹, Tiago da Silva Alexandre², Anita Liberalesso Neri³, Roberta de Oliveira Máximo⁴, Marcela Fernandes Silva³, Cesar de Oliveira⁵

Affiliations

¹ Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil. Electronic address: flarbex@hotmail.com.
² Department of Epidemiology and Public Health, University College London, London, United Kingdom; Department of Gerontology, Federal University of Sao Carlos, Sao Carlos, Brazil.
³ Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.
⁴ Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Brazil.
⁵ Department of Epidemiology and Public Health, University College London, London, United Kingdom.

PMID: 30077597
DOI: 10.1016/j.jamda.2018.06.006

Abstract

Background and objective: There is little epidemiologic evidence considering the combined effect of dynapenia and low 25-hydroxyvitamin D [25 (OH) D] on incident disability. Our aim was to investigate whether the combination of dynapenia and low 25 (OH) D serum levels increases the risk of activities of daily living (ADL) incident disability.

Design: Prospective cohort study.

Settings: English Longitudinal Study of Aging.

Participants: A total of 4630 community-dwelling adults aged 50 years and older without ADL disability at baseline.

Measurements: The baseline sample was categorized into 4 groups (ie, nondynapenic/normal 25 (OH) D, low 25 (OH) D only, dynapenic only, and dynapenic/low 25 (OH) D according to their handgrip strength (<26 kg for men and <16 kg for women) and 25 (OH) D (≤50 nmol/L). The outcome was the presence of any ADL disability 2 years after baseline according to the modified Katz Index. Incidence rate ratios (IRRs) adjusted by sociodemographic, behavioral, and clinical characteristics were estimated using Poisson regression.

Results: The fully adjusted model showed that older adults with dynapenia only and those with lower serum levels of 25 (OH) D combined with dynapenia had higher incident ADL disability risk compared with nondynapenic and those with normal serum levels of 25 (OH) D. The IRRs for lower 25 (OH) D serum levels combined with dynapenia were higher than for dynapenia only, however, the confidence intervals (CIs) showed similar effect for these 2 groups. The IRRs were 1.31 for low 25(OH) D only (95% CI 0.99-1.74), 1.77 for dynapenia only (95% CI 1.08-2.88), and 1.94 for combined dynapenia and low 25(OH)D (95% CI 1.28-2.94).

Conclusions: Dynapenia only and dynapenia combined with low 25 (OH) D serum levels were important risk factors for ADL disability in middle-aged individuals and older adults in 2 years of follow-up.

Keywords: 25(OH) D; Handgrip; muscle strength; vitamin D.

Publication types

Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Disability Evaluation*
England
Female
Hand Strength / physiology
Humans
Incidence
Independent Living
Male
Middle Aged
Muscle Weakness / physiopathology*
Prospective Studies
Risk Factors
Vitamin D Deficiency / physiopathology*

Grants and funding

R01 AG017644/AG/NIA NIH HHS/United States