Vitamin and Carotenoid Status in Older Women: Associations With the Frailty Syndrome

The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences (Impact Factor: 5.42). 07/2006; 61(6):600-7. DOI: 10.1093/gerona/61.6.600
Source: PubMed


We investigated the relationship of micronutrient deficiencies with the frailty syndrome in older women living in the community.
Frailty status and serum micronutrients were assessed in a cross-sectional study of 754 women, 70-80 years old, from the Women's Health and Aging Studies I and II.
Among nonfrail, prefrail, and frail women, respectively, geometric mean serum concentrations were 1.842, 1.593, and 1.376 micromol/L for total carotenoids (p <.001); 2.66, 2.51, and 2.43 micromol/L for retinol (p =.04); 50.9, 47.4, and 43.8 nmol/L for 25-hydroxyvitamin D (p =.019); 43.0, 35.8, and 30.9 nmol/L for vitamin B(6) (p =.002); and 10.2, 9.3, and 8.7 ng/mL for folate (p =.03). Frail women were more likely to have at least two or more micronutrient deficiencies (p =.05). The age-adjusted odds ratios of being frail were significantly higher for those participants whose micronutrient concentrations were in the lowest quartile compared to the top three quartiles for total carotenoids, alpha-tocopherol, 25-hydroxyvitamin D, and vitamin B(6). The association between nutrients and frailty was strongest for beta-carotene, lutein/zeaxanthin, and total carotenoids (odds ratio ranging from 1.82 to 2.45, p =.05), after adjusting for age, sociodemographic status, smoking status, and body mass index.
Frail women are more likely to have relatively low serum carotenoid and micronutrient concentrations and are more likely to have multiple micronutrient deficiencies. Future longitudinal studies are needed to examine the relationships between micronutrient concentrations and frailty in older women.

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Available from: Linda P Fried, Jan 23, 2016
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    • "In Canadian adults aged 60–75 years, odds for sarcopenia were greater in those who reported failing to meet recommended dietary allowances for the antioxidants selenium and vitamins A, C and E [66], and in the HCS a positive association was observed for hand grip strength with β-carotene, selenium and vitamin C [67]. In the Women’s Health and Aging Study (WHAS) of nearly 700 community-dwelling women aged 70–79 years, high plasma carotenoid and α-tocopherol (a form of vitamin E) status were associated with reduced odds for low muscle strength [68] and frailty [69]. Over 3 years in this study, low plasma carotenoid status at baseline predicted development of frailty [70], walking disability [71, 72] and ADL disability [73]. "
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    ABSTRACT: Background Sarcopenia, the age-related decline in skeletal muscle mass and function, is a relatively poorly understood process which may play an important role in the incidence of physical disability and falls in older adults. Evidence demonstrates that both genetic and environmental factors contribute to increased susceptibility for sarcopenia development, yet some of these factors may represent unavoidable consequences of ageing. Methods A review of literature, generally from epidemiological research, was performed to examine the influence that potentially modifiable lifestyle factors (general physical activity, dietary nutrient intake and sun exposure), as well as chronic disease and medication use, may have on sarcopenia progression. Results The review demonstrated that while physical activity, nutrient intake and sun exposure often decline during ageing, each may have important but differing benefits for the prevention of muscle mass and functional declines in older adults. Conversely, age-related increases in the prevalence of chronic diseases and the subsequent prescription of pharmacotherapy may exacerbate sarcopenia progression. Conclusions The prevalence of poor physical activity, diet and sun exposure, as well as chronic disease and medication use, within older adult populations may be modifiable through simple lifestyle and health care interventions. As such, these factors may represent the most effective targets for sarcopenia prevention during the ageing process.
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    • "Many factors have been associated with frailty (Bartali et al., 2006; Barzilay et al., 2007; Cappola et al., 2003; Leng, Xue, Tian, Walston, & Fried, 2007; Michelon et al., 2006; Semba et al., 2006). Broadly categorized, these factors include intrinsic physiologic aging changes (Cappola et al., 2003; Morley & Baumgartner, 2004), diseases and conditions such as heart failure and cancer (Cohen & Mather, 2007), and factors extrinsic to the individual, such as low nutrient intake (Bartali et al., 2006). "
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    ABSTRACT: Frailty involves decrements in many physiologic systems, is prevalent in older ages, and is characterized by increased vulnerability to disability and mortality. It is yet unclear how this geriatric syndrome relates to a preclinical cumulative marker of multisystem dysregulation. The purpose of this study was to evaluate whether allostatic load (AL) was associated with the geriatric syndrome of frailty in older community-dwelling women. We examined the cross-sectional relationship between AL and a validated measure of frailty in the baseline examination of two complementary population-based cohort studies, the Women's Health and Aging studies (WHAS) I and II. This sample of 728 women had an age range of 70-79. We used ordinal logistic regression to estimate the relationship between AL and frailty controlling for covariates. About 10% of women were frail and 46% were prefrail. AL ranged from 0 to 8 with 91% of participants scoring between 0 and 4. Regression models showed that a unit increase in the AL score was associated with increasing levels of frailty (OR = 1.16, 95% CI = 1.04-1.28) controlling for race, age, education, smoking status, and comorbidities. This study suggests that frailty is associated with AL. The observed relationship provides some support for the hypothesis that accumulation of physiological dysregulation may be related to the loss of reserve characterized by frailty.
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    • "Bandeen-Roche et al. 2006; Blaum et al. 2005; Boyd et al. 2005; Michelon et al. 2006; Schmaltz et al. 2005; Semba et al. 2006. d Woods et al. 2005. "
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    ABSTRACT: Frailty is increasingly recognized as a geriatric syndrome that shares common biomedical determinants with rapid muscle fatigue: aging, disease, inflammation, physical inactivity, malnutrition, hormone deficiencies, subjective fatigue, and changes in neuromuscular function and structure. In addition, there is an established relationship between muscle fatigue and core elements of the cycle of frailty as proposed by Fried and colleagues (sarcopenia, neuroendocrine dysregulation and immunologic dysfunction, muscle weakness, subjective fatigue, reduced physical activity, low gait speed, and weight loss). These relationships suggest that frailty and muscle fatigue are closely related and that low tolerance for muscular work may be an indicator of frailty phenotype.
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