Relationship of 25-hydroxyvitamin D with all-cause and cardiovascular disease mortality in older community-dwelling adults

Background/Objectives: Vitamin D deficiency is associated with cardiovascular disease, osteoporosis, poor muscle strength, falls, fractures and mortality. Although older adults are at a higher risk of vitamin D deficiency, the relationship of serum 25-hydroxyvitamin D (25(OH) D) with all-cause and cardiovascular disease mortality has not been well characterized in the elderly. We hypothesized that low serum 25(OH) D levels predicted mortality in older adults. Subjects/Methods: Serum 25(OH) D as well as all-cause and cardiovascular disease mortality were examined in 1006 adults, aged >= 65 years, who participated in the InCHIANTI (Invecchiare in Chianti, Aging in the Chianti Area) study, a population-based, prospective cohort study of aging in Tuscany, Italy. Serum 25(OH) D levels were measured at the time of enrollment in 1998-1999, and participants were followed up for mortality. Results: During 6.5 years of follow-up, 228 (22.7%) participants died, of whom 107 died due to cardiovascular diseases. Compared with participants in the highest quartile of serum 25(OH) D (> 26.5 ng/ml) (to convert to nmol/l, multiply by 2.496), those in the lowest quartile (<10.5 ng/ml) had increased risk of all-cause mortality (Hazard Ratio (H.R.) 2.11, 95% Confidence Interval (95% C.I.): 1.22-3.64, P = 0.007) and cardiovascular disease mortality (H.R. 2.64, 95% C.I.: 1.14-4.79, P = 0.02), in multivariate Cox proportional hazards models that adjusted for age, sex, education, season, physical activity and other potential confounders. Conclusions: Older community-dwelling adults with low serum 25(OH) D levels are at higher risk of all-cause and cardiovascular disease mortality. European Journal of Clinical Nutrition (2010) 64, 203-209; doi: 10.1038/ejcn.2009.140; published online 2 December 2009