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Minerals, trace elements, vit. D and bone health

Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people



Serum 25-hydroxyvitamin D (25(OH)D) status has been associated with muscle mass, strength and physical performance in healthy elderly people. Yet, in pre-frail and frail elderly people this association has not been studied. The objective of this study was to explore the association between vitamin D intake and serum 25(OH)D status with muscle mass, strength and physical performance in a pre-frail and frail elderly population.


This cross-sectional study included 127 pre-frail and frail elderly people in The Netherlands. Whole body and appendicular lean mass (ALM) (dual energy X-ray absorptiometry), leg strength (one repetition maximum), handgrip strength and physical performance (short physical performance battery) were measured, and blood samples were collected for the assessment of serum 25(OH)D status (liquid chromatography-tandem mass spectrometry). In addition, habitual dietary intake (3-day food records) and physical activity data (accelerometers) were collected.


In total, 53% of the participants had a serum 25(OH)D level below 50 nmol/l. After adjustment for confounding factors, 25(OH)D status was associated with ALM (β=0.012, P=0.05) and with physical performance (β=0.020, P<0.05). Vitamin D intake was associated with physical performance (β=0.18, P<0.05) but not with ALM (P>0.05).


In this frail elderly population, 25(OH)D status is low and suggests a modest association with reduced ALM and impaired physical performance. In addition, vitamin D intake tended to be associated with impaired physical performance. Our findings highlight the need for well-designed intervention trials to assess the impact of vitamin D supplementation on 25(OH)D status, muscle mass and physical performance in pre-frail and frail elderly people.

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We gratefully acknowledge the expert assistance of Marlou Dirks, Nikita van der Zwaluw, Ondine van de Rest, Antoine Zorenc, Lex Verdijk, Marco Mensink, Lucy Okma, Jantien Takens, Fenglian Hu, Lieneke Homans and all volunteers and students that participated in this study. Furthermore, we greatly acknowledge all the elderly subjects who volunteered to participate in this study.

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Tieland, M., Brouwer-Brolsma, E., Nienaber-Rousseau, C. et al. Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people. Eur J Clin Nutr 67, 1050–1055 (2013).

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  • vitamin D
  • aging
  • muscle function
  • frailty
  • sarcopenia

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