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Published in: International Urology and Nephrology 4/2019

01-04-2019 | Nephrology - Original Paper

Functional capacity, renal function and vitamin D in community-dwelling oldest old

Authors: Lara Miguel Quirino Araujo, Patricia Ferreira do Prado Moreira, Clineu de Mello Almada Filho, Luciano Vieira de Araujo, Michelle Tiveron Passos, Gianna Mastroianni Kirsztajn, Miguel Cendoroglo Neto, Ricardo Castro Cintra Sesso, Maysa Seabra Cendoroglo

Published in: International Urology and Nephrology | Issue 4/2019

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Abstract

Purpose

The aim of this study was to evaluate the association between the decline in estimated glomerular filtration rate (eGFR) and serum 25(OH)D with the physical and mental functional capacity of elderly individuals aged 80 years or older.

Methods

We evaluated the functional capacity in its multidomain aspects: Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Mental State Mini-Exam (MMSE), Verbal Fluency Test (VF), handgrip strength and time to sit and rise from a chair five times, combined creatinine and cystatin C-based eGFR and 25(OH)D levels in 205 independent asymptomatic and community-dwelling elderly subjects in a cross-sectional study.

Results

Every 1 year of life, there was reduction of about 10% chance of adequate performance in functional capacity. Each 1 ml/min/m2 in eGFR was associated with 2% better chance of adequate performance in the IADL. We found no association between eGFR and cognition. Serum 25(OH)D between 15.00 and 22.29 ng/ml increased the chance of better performance in VF, IADL, handgrip strength and sit and rise from the chair compared to the lower level of serum vitamin D.

Conclusions

Decreased renal function associated with age compromises the ability to perform activities for independent life in the community, but we did not observe influence in specific domains of cognition and physical performance. Low serum level of 25(OH)D appears to be a marker of greater risk of functional decline than eGFR measurement in independent oldest old dwelling in the community.
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Literature
1.
go back to reference Annweiler C, Dursun E, Féron F, Gezen-Ak D, Kalueff AV, Littlejohns T, Llewellyn DJ, Millet P, Scott T, Tucker KL, Yilmazer S, Beauchet O (2015) ‘Vitamin D and cognition in older adults’: updated international recommendations. J Int Med 277(1):45–57CrossRef Annweiler C, Dursun E, Féron F, Gezen-Ak D, Kalueff AV, Littlejohns T, Llewellyn DJ, Millet P, Scott T, Tucker KL, Yilmazer S, Beauchet O (2015) ‘Vitamin D and cognition in older adults’: updated international recommendations. J Int Med 277(1):45–57CrossRef
2.
go back to reference Kositsawat J, Barry LC, Kuchel GA (2013) C-reactive protein, vitamin D deficiency, and slow gait speed. J Am Geriatr Soc 61(9):1574–1579CrossRefPubMed Kositsawat J, Barry LC, Kuchel GA (2013) C-reactive protein, vitamin D deficiency, and slow gait speed. J Am Geriatr Soc 61(9):1574–1579CrossRefPubMed
3.
go back to reference Lagari V, Gómez-Marín O, Levis S (2013) The role of vitamin D in improving physical performance in the elderly. J Bone Miner Res 28(10):2194–2201CrossRefPubMed Lagari V, Gómez-Marín O, Levis S (2013) The role of vitamin D in improving physical performance in the elderly. J Bone Miner Res 28(10):2194–2201CrossRefPubMed
4.
go back to reference Buell JS, Dawson-Hughes B, Scott TM, Weiner DE, Dallal GE, Qui WQ, Bergethon P, Rosenberg IH, Folstein MF, Patz S, Bhadelia RA, Tucker KL (2010) 25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services. Neurology 74(1):18–26CrossRefPubMedPubMedCentral Buell JS, Dawson-Hughes B, Scott TM, Weiner DE, Dallal GE, Qui WQ, Bergethon P, Rosenberg IH, Folstein MF, Patz S, Bhadelia RA, Tucker KL (2010) 25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services. Neurology 74(1):18–26CrossRefPubMedPubMedCentral
5.
go back to reference Shaffi K, Tighiouart H, Scott T, Lou K, Drew D, Weiner D, Sarnak M (2013) Low 25-hydroxyvitamin D levels and cognitive impairment in hemodialysis patients. Clin J Am Soc Nephrol 8(6):979–986CrossRefPubMedPubMedCentral Shaffi K, Tighiouart H, Scott T, Lou K, Drew D, Weiner D, Sarnak M (2013) Low 25-hydroxyvitamin D levels and cognitive impairment in hemodialysis patients. Clin J Am Soc Nephrol 8(6):979–986CrossRefPubMedPubMedCentral
6.
go back to reference Sun X, Cao ZB, Zhang Y, Ishimi Y, Tabata I, Higuchi M (2014) Association between serum 25-hydroxyvitamin D and inflammatory cytokines in healthy adults. Nutrients 6(1):221–230CrossRefPubMedPubMedCentral Sun X, Cao ZB, Zhang Y, Ishimi Y, Tabata I, Higuchi M (2014) Association between serum 25-hydroxyvitamin D and inflammatory cytokines in healthy adults. Nutrients 6(1):221–230CrossRefPubMedPubMedCentral
7.
8.
go back to reference McCarthy EK, Kiely M (2015) Vitamin D and muscle strength throughout the life course: a review of epidemiological and intervention studies. J Hum Nutr Diet 28(6):636–645CrossRefPubMed McCarthy EK, Kiely M (2015) Vitamin D and muscle strength throughout the life course: a review of epidemiological and intervention studies. J Hum Nutr Diet 28(6):636–645CrossRefPubMed
9.
go back to reference Jones G (2007) Expanding role for vitamin D in chronic kidney disease: importance of blood 25-OH-D levels and extra-renal 1alpha-hydroxylase in the classical and nonclassical actions of 1alpha,25-dihydroxyvitamin D(3). Semin Dial 20(4):316–324CrossRefPubMed Jones G (2007) Expanding role for vitamin D in chronic kidney disease: importance of blood 25-OH-D levels and extra-renal 1alpha-hydroxylase in the classical and nonclassical actions of 1alpha,25-dihydroxyvitamin D(3). Semin Dial 20(4):316–324CrossRefPubMed
10.
go back to reference Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D (2004) Predictors of new-onset kidney disease in a community-based population. JAMA 291(7):844–850CrossRefPubMed Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D (2004) Predictors of new-onset kidney disease in a community-based population. JAMA 291(7):844–850CrossRefPubMed
11.
go back to reference Rule AD, Amer H, Cornell LD, Taler SJ, Cosio FG, Kremers WK, Textor SC, Stegall MD (2010) The association between age and nephrosclerosis on renal biopsy among healthy adults. Ann Int Med 152(9):561–567CrossRefPubMed Rule AD, Amer H, Cornell LD, Taler SJ, Cosio FG, Kremers WK, Textor SC, Stegall MD (2010) The association between age and nephrosclerosis on renal biopsy among healthy adults. Ann Int Med 152(9):561–567CrossRefPubMed
12.
go back to reference Lindeman RD, Tobin J, Shock NW (1985) Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 33(4):278–285CrossRefPubMed Lindeman RD, Tobin J, Shock NW (1985) Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 33(4):278–285CrossRefPubMed
13.
go back to reference Shastri S, Katz R, Rifkin DE, Fried LF, Odden MC, Peralta CA, Chonchol M, Siscovick D, Shlipak MG, Newman AB, Sarnak MJ (2012) Kidney function and mortality in octogenarians: cardiovascular Health Study All Stars. J Am Geriatr Soc 60(7):1201–1207CrossRefPubMedPubMedCentral Shastri S, Katz R, Rifkin DE, Fried LF, Odden MC, Peralta CA, Chonchol M, Siscovick D, Shlipak MG, Newman AB, Sarnak MJ (2012) Kidney function and mortality in octogenarians: cardiovascular Health Study All Stars. J Am Geriatr Soc 60(7):1201–1207CrossRefPubMedPubMedCentral
14.
go back to reference Kurella Tamura M, Wadley V, Yaffe K, McClure LA, Howard G, Go R et al (2008) Kidney function and cognitive impairment in US adults: the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Am J Kidney Dis 52(2):227–234CrossRefPubMedPubMedCentral Kurella Tamura M, Wadley V, Yaffe K, McClure LA, Howard G, Go R et al (2008) Kidney function and cognitive impairment in US adults: the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Am J Kidney Dis 52(2):227–234CrossRefPubMedPubMedCentral
15.
go back to reference Elias MF, Elias PK, Seliger SL, Narsipur SS, Dore GA, Robbins MA (2009) Chronic kidney disease creatinine and cognitive functioning. Nephrol Dial Transplant 24(8):2446–2452CrossRefPubMedPubMedCentral Elias MF, Elias PK, Seliger SL, Narsipur SS, Dore GA, Robbins MA (2009) Chronic kidney disease creatinine and cognitive functioning. Nephrol Dial Transplant 24(8):2446–2452CrossRefPubMedPubMedCentral
16.
go back to reference Yaffe K, Lindquist K, Shlipak MG, Simonsick E, Fried L, Rosano C et al (2008) Cystatin C as a marker of cognitive function in elders: findings from the health ABC study. Ann Neurol 63(6):798–802CrossRefPubMedPubMedCentral Yaffe K, Lindquist K, Shlipak MG, Simonsick E, Fried L, Rosano C et al (2008) Cystatin C as a marker of cognitive function in elders: findings from the health ABC study. Ann Neurol 63(6):798–802CrossRefPubMedPubMedCentral
17.
go back to reference Feng L, Yap KB, Yeoh LY, Ng TP (2012) Kidney function and cognitive and functional decline in elderly adults: findings from the Singapore longitudinal aging study. J Am Geriatr Soc 60(7):1208–1214CrossRefPubMed Feng L, Yap KB, Yeoh LY, Ng TP (2012) Kidney function and cognitive and functional decline in elderly adults: findings from the Singapore longitudinal aging study. J Am Geriatr Soc 60(7):1208–1214CrossRefPubMed
18.
go back to reference Yaffe K, Ackerson L, Kurella Tamura M, Le Blanc P, Kusek JW, Sehgal AR, Cohen D, Anderson C, Appel L, Desalvo K, Ojo A, Seliger S, Robinson N, Makos G, Go AS, Chronic Renal Insufficiency Cohort Investigators (2010) Chronic kidney disease and cognitive function in older adults: findings from the chronic renal insufficiency cohort cognitive study. J Am Geriatr Soc 58(2):338–345CrossRefPubMedPubMedCentral Yaffe K, Ackerson L, Kurella Tamura M, Le Blanc P, Kusek JW, Sehgal AR, Cohen D, Anderson C, Appel L, Desalvo K, Ojo A, Seliger S, Robinson N, Makos G, Go AS, Chronic Renal Insufficiency Cohort Investigators (2010) Chronic kidney disease and cognitive function in older adults: findings from the chronic renal insufficiency cohort cognitive study. J Am Geriatr Soc 58(2):338–345CrossRefPubMedPubMedCentral
19.
go back to reference Roshanravan B, Robinson-Cohen C, Patel KV, Ayers E, Littman AJ, de Boer IH, Ikizler TA, Himmelfarb J, Katzel LI, Kestenbaum B, Seliger S (2013) Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol 24(5):822–830CrossRefPubMedPubMedCentral Roshanravan B, Robinson-Cohen C, Patel KV, Ayers E, Littman AJ, de Boer IH, Ikizler TA, Himmelfarb J, Katzel LI, Kestenbaum B, Seliger S (2013) Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol 24(5):822–830CrossRefPubMedPubMedCentral
20.
go back to reference Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefPubMed Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefPubMed
21.
go back to reference Lawton MP, Brody EM (1969) Assessment of older people: self-maintain in hand instrumental activities of daily living. Gerontologist 9(3):179–186CrossRef Lawton MP, Brody EM (1969) Assessment of older people: self-maintain in hand instrumental activities of daily living. Gerontologist 9(3):179–186CrossRef
22.
go back to reference Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1983) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17(1):37–49CrossRef Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1983) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17(1):37–49CrossRef
23.
go back to reference Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH (2003) Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr 61(3B):777–781CrossRefPubMed Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH (2003) Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr 61(3B):777–781CrossRefPubMed
24.
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRef Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRef
25.
go back to reference Brucki SM, Rocha MS (2004) Category fluency test: effects of age. Gender and education on total scores. Clustering and switching in Brazilian Portuguese-speaking subjects. Braz J Med Biol Res 37(12):1771–1777CrossRefPubMed Brucki SM, Rocha MS (2004) Category fluency test: effects of age. Gender and education on total scores. Clustering and switching in Brazilian Portuguese-speaking subjects. Braz J Med Biol Res 37(12):1771–1777CrossRefPubMed
26.
go back to reference Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–M94CrossRefPubMed Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–M94CrossRefPubMed
27.
go back to reference Roberts HC. Denison HJ. Martin HJ. Patel HP. Syddall H. Cooper C. Sayer AA (2011) A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing 40(4):423–429CrossRefPubMed Roberts HC. Denison HJ. Martin HJ. Patel HP. Syddall H. Cooper C. Sayer AA (2011) A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing 40(4):423–429CrossRefPubMed
28.
go back to reference Alley DE, Shardell MD, Peters KW, McLean RR, Dam TT, Kenny AM, Fragala MS, Harris TB, Kiel DP, Guralnik JM, Ferrucci L, Kritchevsky SB, Studenski SA, Vassileva MT, Cawthon PM (2014) Grip strength cutpoints for the identification of clinically relevant weakness. J Gerontol A 69(5):559–566CrossRef Alley DE, Shardell MD, Peters KW, McLean RR, Dam TT, Kenny AM, Fragala MS, Harris TB, Kiel DP, Guralnik JM, Ferrucci L, Kritchevsky SB, Studenski SA, Vassileva MT, Cawthon PM (2014) Grip strength cutpoints for the identification of clinically relevant weakness. J Gerontol A 69(5):559–566CrossRef
29.
go back to reference Lopes MB, Araújo LQ, Passos MT, Nishida SK, Kirsztajn GM, Cendoroglo MS, Sesso RC (2013) Estimation of glomerular filtration rate from serum creatinine and cystatin C in octogenarians and nonagenarians. BMC Nephrol 14:265CrossRefPubMedPubMedCentral Lopes MB, Araújo LQ, Passos MT, Nishida SK, Kirsztajn GM, Cendoroglo MS, Sesso RC (2013) Estimation of glomerular filtration rate from serum creatinine and cystatin C in octogenarians and nonagenarians. BMC Nephrol 14:265CrossRefPubMedPubMedCentral
30.
go back to reference Bowling CB, Sawyer P, Campbell RC, Ahmed A, Allman RM (2011) Impact of chronic kidney disease on activities of daily living in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 66(6):689–694CrossRefPubMed Bowling CB, Sawyer P, Campbell RC, Ahmed A, Allman RM (2011) Impact of chronic kidney disease on activities of daily living in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 66(6):689–694CrossRefPubMed
31.
go back to reference Formiga F, Ferrer A, Almeda J, San Jose A, Gil A, Pujol R (2011) Utility of geriatric assessment tools to identify 85-years old subjects with vitamin D deficiency. J Nutr Health Aging 15(2):110–114CrossRefPubMed Formiga F, Ferrer A, Almeda J, San Jose A, Gil A, Pujol R (2011) Utility of geriatric assessment tools to identify 85-years old subjects with vitamin D deficiency. J Nutr Health Aging 15(2):110–114CrossRefPubMed
32.
go back to reference Bowling CB, Booth JN 3rd, Gutiérrez OM, Kurella Tamura M, Huang L, Kilgore M, Judd S, Warnock DG, McClellan WM, Allman RM, Muntner P (2014) Nondisease-specific problems and all-cause mortality among older adults with CKD: the REGARDS study. Clin J Am Soc Nephrol 9(10):1737–1745CrossRefPubMedPubMedCentral Bowling CB, Booth JN 3rd, Gutiérrez OM, Kurella Tamura M, Huang L, Kilgore M, Judd S, Warnock DG, McClellan WM, Allman RM, Muntner P (2014) Nondisease-specific problems and all-cause mortality among older adults with CKD: the REGARDS study. Clin J Am Soc Nephrol 9(10):1737–1745CrossRefPubMedPubMedCentral
33.
go back to reference Bowling CB, Muntner P, Sawyer P, Sanders PW, Kutner N, Kennedy R, Allman RM (2014) Community mobility among older adults with reduced kidney function: a studyoflife-space. Am J KidneyDis 63(3):429–436CrossRef Bowling CB, Muntner P, Sawyer P, Sanders PW, Kutner N, Kennedy R, Allman RM (2014) Community mobility among older adults with reduced kidney function: a studyoflife-space. Am J KidneyDis 63(3):429–436CrossRef
34.
go back to reference Kurella M, Chertow GM, Fried LF, Cummings SR, Harris T, Simonsick E, Satterfield S, Ayonayon H, Yaffe K (2005) Chronic kidney disease and cognitive impairment in the elderly: the health, aging, and body composition study. J Am Soc Nephrol 16(7):2127–2133CrossRefPubMed Kurella M, Chertow GM, Fried LF, Cummings SR, Harris T, Simonsick E, Satterfield S, Ayonayon H, Yaffe K (2005) Chronic kidney disease and cognitive impairment in the elderly: the health, aging, and body composition study. J Am Soc Nephrol 16(7):2127–2133CrossRefPubMed
35.
go back to reference Van Pottelbergh G, Den Elzen WP, Degryse J, Gussekloo J (2013) Prediction of mortality and functional decline by changes in eGFR in the very elderly: the Leiden 85-plus study. BMC Geriatr 13:61CrossRefPubMedPubMedCentral Van Pottelbergh G, Den Elzen WP, Degryse J, Gussekloo J (2013) Prediction of mortality and functional decline by changes in eGFR in the very elderly: the Leiden 85-plus study. BMC Geriatr 13:61CrossRefPubMedPubMedCentral
36.
go back to reference Gschwind YJ, Bischoff-Ferrari HA, Bridenbaugh SA, Härdi I, Kressig RW (2014) Association between serum vitamin D status and functional mobility in memory clinic patients aged 65 years and older. Gerontology 60(2):123–129CrossRefPubMed Gschwind YJ, Bischoff-Ferrari HA, Bridenbaugh SA, Härdi I, Kressig RW (2014) Association between serum vitamin D status and functional mobility in memory clinic patients aged 65 years and older. Gerontology 60(2):123–129CrossRefPubMed
37.
go back to reference Matheï C, Van Pottelbergh G, Vaes B, Adriaensen W, Gruson D, Degryse JM (2013) No relation between vitamin D status and physical performance in the oldest old: results from the Belfrail study. Age Ageing 42(2):186–190CrossRefPubMed Matheï C, Van Pottelbergh G, Vaes B, Adriaensen W, Gruson D, Degryse JM (2013) No relation between vitamin D status and physical performance in the oldest old: results from the Belfrail study. Age Ageing 42(2):186–190CrossRefPubMed
38.
go back to reference Skalska A, Gałaś A, Grodzicki T (2012) 25-Hydroxyvitamin D and physical and cognitive performance in older people with chronic conditions. Pol Arch Med Wewn 122(4):162–169PubMed Skalska A, Gałaś A, Grodzicki T (2012) 25-Hydroxyvitamin D and physical and cognitive performance in older people with chronic conditions. Pol Arch Med Wewn 122(4):162–169PubMed
Metadata
Title
Functional capacity, renal function and vitamin D in community-dwelling oldest old
Authors
Lara Miguel Quirino Araujo
Patricia Ferreira do Prado Moreira
Clineu de Mello Almada Filho
Luciano Vieira de Araujo
Michelle Tiveron Passos
Gianna Mastroianni Kirsztajn
Miguel Cendoroglo Neto
Ricardo Castro Cintra Sesso
Maysa Seabra Cendoroglo
Publication date
01-04-2019
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 4/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-019-02081-w

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