Vitamin D and walking speed in older adults: Systematic review and meta-analysis.

Cedric Annweiler, Samir Henni, Stéphane Walrand, Manuel Montero-Odasso, Gustavo Duque, Guillaume T Duval

Journal: Maturitas 2018;106():8-25

PMID: 29150169

Full Text on Elsevier Science View on PubMed

Abstract

Vitamin D is involved in musculoskeletal health. There is no consensus on a possible association between circulating 25-hydroxyvitamin D (25OHD) concentrations and walking speed, a 'vital sign' in older adults. Our objective was to systematically review and quantitatively assess the association of 25OHD concentration with walking speed. A Medline search was conducted on June 2017, with no limit of date, using the MeSH terms "Vitamin D" OR "Vitamin D Deficiency" combined with "Gait" OR "Gait disorders, Neurologic" OR "Walking speed" OR "Gait velocity". Fixed-effect meta-analyses were performed to compute: i) mean differences in usual and fast walking speeds and Timed Up and Go test (TUG) between participants with severe vitamin D deficiency (≤25nmol/L) (SVDD), vitamin D deficiency (≤50nmol/L) (VDD), vitamin D insufficiency (≤75nmol/L) (VDI) and normal vitamin D (>75nmol/L) (NVD); ii) risk of slow walking speed according to vitamin D status. Of the 243 retrieved studies, 22 observational studies (17 cross-sectional, 5 longitudinal) met the selection criteria. The number of participants ranged between 54 and 4100 (0-100% female). Usual walking speed was slower among participants with hypovitaminosis D, with a clinically relevant difference compared with NVD of -0.18m/s for SVDD, -0.08m/s for VDD and -0.12m/s for VDI. We found similar results regarding the fast walking speed (mean differences -0.04m/s for VDD and VDI compared with NVD) and TUG (mean difference 0.48s for SVDD compared with NVD). A slow usual walking speed was positively associated with SVDD (summary OR=2.17[95%CI:1.52-3.10]), VDD (OR=1.38[95%CI:1.01-1.89]) and VDI (OR=1.38[95%CI:1.04-1.83]), using NVD as the reference. In conclusion, this meta-analysis provides robust evidence that 25OHD concentrations are positively associated with walking speed among adults.

Address: Department of Neuroscience and Aging, Division of Geriatric Medicine and Memory Clinic, Research Centre on Autonomy and Longevity, Angers University Hospital, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. Electronic address: [email protected].; Department of Sports Medicine and Vascular Investigations, University Hospital, Angers, France.; Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000 Clermont-Ferrand, France.; Department of Medicine, Division of Geriatric Medicine, Parkwood Institute, Gait and Brain Lab, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada.; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health,St. Albans, Victoria, Australia; Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St. Albans, Victoria, Australia.; Department of Neuroscience and Aging, Division of Geriatric Medicine and Memory Clinic, Research Centre on Autonomy and Longevity, Angers University Hospital, UPRES EA 4638, University of Angers, UNAM, Angers, France.

DOI: 10.1016/j.maturitas.2017.07.012