Vitamin D and muscle function in the elderly: the elixir of youth?
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D supplementation | decrease | falls | frail, elderly subjects | - | may benefit from | #1 |
vitamin D supplementation | increase | muscle function | frail, elderly subjects | - | improved | #2 |
vitamin D supplementation | increase | muscle fibre size | frail, elderly subjects | - | increased | #3 |
vitamin D | no change | - | the elderly | - | do not report convincing effects of | #4 |
vitamin D deficiency | increase | age-related changes in skeletal muscle | - | - | may contribute to | #5 |
vitamin D deficiency | increase | ageing of skeletal muscle | - | - | may exacerbate | #6 |
vitamin D supplementation | no change | age-related muscle dysfunction | the elderly | - | does not justify stringent vitamin D targets | #7 |
PURPOSE OF REVIEW: Circumstantial evidence suggests that vitamin D deficiency may contribute to age-related changes in skeletal muscle. This review discusses recent clinical trials examining effects of vitamin D on muscle function in the elderly, and poses the important question: can vitamin D reverse muscle ageing? RECENT FINDINGS: Observational studies report an association between vitamin D and muscle atrophy/weakness in elderly subjects. Interventional studies suggest that frail, elderly subjects may benefit from vitamin D supplementation by displaying reduced falls, improved muscle function and increased muscle fibre size. However, meta-analyses do not report convincing effects of vitamin D in the elderly. This may be because of multiple factors including lack of standardized endpoints for muscle function, variable study design and different doses of vitamin D supplementation amongst these studies. The evidence base is therefore inconsistent. SUMMARY: Vitamin D deficiency may exacerbate ageing of skeletal muscle. However, current evidence that vitamin D supplementation reverses age-related muscle dysfunction is equivocal and does not justify stringent vitamin D targets in the elderly. Until these issues are clarified, the safest option is to aim for conservative vitamin D targets that are sufficient for normal calcium homeostasis.