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Annales de Gérontologie

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Vitamin D deficiency as a contributor of the fraitly syndrome Volume 2, issue 4, décembre 2009

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Authors
Assistant professor of medicine,epidemiology and biostatistics,division of geriatric medicine;University of Western Ontarioscientist, lawson researchInstitute, London, ON Canada, Postdoctoal fellow, division of geriatric medicine,University of Western Ontario,London, ON Canada

The age-associated reduction in skeletal muscle mass (sarcopenia) is one of the main components of frailty. In the last decade several observational studies have associated sarcopenia with frailty. Interestingly, the myopathy associated with vitamin D deficiency described decades ago has similar anatomical characteristics to what we now attribute to sarcopenia. Epidemiological studies have shown an association with vitamin D deficiency and sarcopenia in older adults, and recently, it has been shown that this association between sarcopenia and vitamin D deficiency increases with age. Clinical trials have found an effect of vitamin D on muscle function, balance and clinical outcomes related to frailty, such as falls and fractures, in older persons with low vitamin D serum levels and doses of at least 800 IU. By contrast, this effect was not seen in studies using lower doses of vitamin D (< 800 IU/day) or without calcium supplementation. There is a compelling rationale to believe there is a potential beneficial effect of vitamin D on neuromuscular function in frail older persons. Low doses of vitamin D have been tested but little work has looked at high doses looking at muscle function outcomes. We will review recent evidence of the effect of higher doses of vitamin D on muscle function and sarcopenia in frail older adults and we will present preliminary data of the studies targeting sarcopenia and mobility decline in frail populations