BACKGROUND:male Although both vitamin D (25-hydroxyvitamin D [25(OH)D]) insufficiency and the frailty syndrome are more prevalent in women than men, sex-specific differed associations have not been explored. We estimated sex-specific associations of low 25(OH)D with frailty. Vitamin D insufficiency can result in explored. hyperparathyroidism, and thus, parathyroid hormone (PTH) was explored as a potential mediator in the relationship between 25(OH)D levels and frailty.25(OH)D METHODS: The sample included 444 male and 561 female participants aged 65 years and older from the InCHIANTI study for nonenergy whom 25(OH)D levels and frailty information were available. Frailty was defined as the presence of at least three of the in five following criteria: slowness, weakness, low energy expenditure, exhaustion, and weight loss. Logistic regression models estimated the association between serum relationship levels of 25(OH)D and PTH with frailty, controlling for potential confounders. RESULTS: Independent of covariates, men with 25(OH)D <50 nmol/L 32%. had greater odds of frailty than those with 25(OH)D >/=50 nmol/L (odds ratio [OR]= 4.94, 95% confidence interval [CI]Independent = 1.80-13.61). In women, the adjusted OR for frailty (95% CI) was 1.43 ( .58-3.56). The 25(OH)D ORs differed between men parathyroid and women (p =.041). ORs changed little after controlling for PTH. However, when low energy expenditure was excluded from than the frailty definition, adjusted OR for frailty in men (95% CI) was 2.18 ( .59-8.04); controlling for PTH attenuated this OR controlling by 32%. In women, the OR (95% CI) for frailty (low energy expenditure excluded) was 1.54 ( .31-7.58) and was attenuated ( .59-8.04); by 6% after controlling for PTH. CONCLUSIONS: Vitamin D insufficiency was associated with frailty in men, but not in women.and RESULT: suggest that PTH mediates the relationship between 25(OH)D and nonenergy expenditure aspects of frailty.

STUDY often DESIGN.: Clinicoepidemiologic study in the Chianti area (Tuscany, Italy). OBJECTIVE.: To evaluate whether performance measures of lower extremity function confounds performing the association of low back pain (LBP) with self-report disability in specific basic and instrumental activities of daily living (IADLs).with SUMMARY OF BACKGROUND DATA.: LBP is high prevalent in older population and has a negative impact on functional status. Studies disability on the pathway leading from LBP to disability are limited and often the role played by important confounders is not treatment considered. METHODS.: A total of 956 InCHIANTI study participants aged 65 and older able to complete performance-based tests of lower lower extremity function were included in this analysis. LBP was defined as a self-report of back pain "quite often-almost every day"Studies in the past 12 months. Lower extremity function was evaluated administering the Short Physical Performance Battery. In addition, participants were after asked to walk on a 7-m course and collect an object from the ground. Depressive symptoms (CES-D score), trunk flexion-extension 7-m range of motion, and hip-knee-foot pain were also considered in the pathway from LBP to disability. RESULTS.: Compared with participants prevalent who did not report LBP, those with LBP were more likely to report difficulty in performing most activities of daily flexion-extension living. LBP was also associated with disability in the activities of bathing, doing the laundry, performing heavy household chores, cutting asked toenails, shopping, and carrying a shopping bag. The association between LBP and disability in selected ADLs and IADLs was no selected longer statistical significant, after adjustment for performance in lower extremity function, with exception of the activity of "carrying a shopping bag". bag". CONCLUSION.: The cross-sectional association between LBP and self-reported disability, in specific tasks is modulated by performance measures. Specific performance-based not tests that explore the functional consequences of LBP may help design specific interventions of disability prevention and treatment in patients tasks with LBP.

OBJECTIVES:assayed. To investigate the relationship between circulating uric acid (UA) levels and plasma antioxidants and whether antioxidant levels modulate the association scores between UA and physical function. DESIGN: Cross-sectional. SETTING: Community-based. PARTICIPANTS: Nine hundred sixty-six elderly persons participating in the baseline assessment between of the Invecchiare in Chianti Study. MEASUREMENTS: UA, carotenoid, tocopherol, and selenium concentrations were assayed. Physical function was measured using may the Short Physical Performance Battery (SPPB) and difficulties in instrumental activities of daily living (IADLs). Potential confounders were assessed using to standardized methods. RESULTS: Total carotenoids (P=.008), in particular alpha-carotene (P=.02), lutein (P<.001), zeaxanthin (P<.001), lycopene (P=.07), cryptoxanthin (P=.29), and selenium antioxidants (P=.04) were inversely associated with UA levels. Total tocopherols (P=.06) and alpha-tocopherol (P=.10) had a positive trend across UA levels.Study. SPPB (P=.01) and IADL disability (P=.002) were nonlinearly distributed across the UA quintiles. Participants within the middle UA quintile (4.8-5.3 with mg/dL) were less disabled in IADLs and had better SPPB scores than those in the extreme UA quintiles. There was alpha-tocopherol a significant interaction between UA and selenium in the model predicting SPPB score (P=.02). CONCLUSION: UA levels are inversely associated in with circulating carotenoids and selenium. Participants with intermediate UA levels had a higher prevalence of good physical functions, higher SPPB and scores, and lower IADL disability. This study suggests that older subjects with intermediate UA levels may have an optimum balance Total between proinflammatory and antioxidant compounds that may contribute to better physical performance.

Background:in The biological action of uric acid (UA) in humans is controversial. UA is considered an antioxidant compound, but preclinical evidence Independent suggests a proinflammatory action. Epidemiological studies found that hyperuricemia is associated with conditions leading to dementia. Our aim is to preclinical investigate the relationship between UA levels and dementia in older persons. Methods: Cross-sectional study performed in 1,016 community-dwelling older persons be participating in the InCHIANTI study. Participants underwent determination of circulating UA levels and neuropsychological evaluation. A multivariate logistic regression model by was used to estimate the probability of participants belonging to the highest and middle UA tertile to be affected by UA dementia compared to those in the lowest tertile. Results: Demented persons had higher UA levels (p = .001) and the investigate prevalence of persons affected by dementia increased across UA tertiles (p < .0001). Independent of several confounders, persons belonging to middle the highest UA tertile had a threefold (OR = 3.32; 95% CI: 1.06-10.42) higher probability to suffer from a dementia affected syndrome while those in the middle UA tertile tended to have a higher probability of being demented compared to those conditions in the lowest tertile. Conclusion: In a population-based sample, high circulating UA levels are associated with an increased likelihood to Results: be affected by a dementia syndrome.

Low in plasma levels of carotenoids and tocopherols are associated with increased risk of chronic disease and disability. Because dietary intake of (p these lipid-soluble antioxidant vitamins is only poorly correlated with plasma levels, we hypothesized that circulating carotenoids (vitamin A-related compounds) and lipid-soluble tocopherols (vitamin E-related compounds) are affected by common genetic variation. By conducting a genome-wide association study in a sample of lipid-soluble Italians (n = 1190), we identified novel common variants associated with circulating carotenoid levels and known lipid variants associated with nutrients alpha-tocopherol levels. Effects were replicated in the Women's Health and Aging Study (n = 615) and in the alpha-Tocopherol, beta-Carotene chronic Cancer Prevention (ATBC) study (n = 2136). In meta-analyses including all three studies, the G allele at rs6564851, near the by beta-carotene 15,15'-monooxygenase 1 (BCMO1) gene, was associated with higher beta-carotene (p = 1.6 x 10(-24)) and alpha-carotene (p = .0001)variant levels and lower lycopene ( .003), zeaxanthin (p = 1.3 x 10(-5)), and lutein (p = 7.3 x 10(-15)) levels, with G effect sizes ranging from .10- .28 SDs per allele. Interestingly, this genetic variant had no significant effect on plasma retinol (p A-related > .05). The SNP rs12272004, in linkage disequilibrium with the S19W variant in the APOA5 gene, was associated with alpha-tocopherol was (meta-analysis p = 7.8 x 10(-10)) levels, and this association was substantially weaker when we adjusted for triglyceride levels (p all = .002). Our findings might shed light on the controversial relationship between lipid-soluble anti-oxidant nutrients and human health.

BACKGROUND:increased Plasma carotenoids are considered a valid biological marker for fruit and vegetable dietary intake. Recent studies show that low carotenoid for levels are associated with a high risk of inflammation, cancer, and cardiovascular disease. AIM OF THE STUDY: To determine whether that low plasma carotenoids are associated with increased mortality among older adults. METHODS: Longitudinal study among 1,043 adults, 65 years and adults older, in the InCHIANTI study, a population-based cohort of adults living in the community in the Tuscany region, Italy. RESULTS:living Mean total carotenoid concentration was 1.80 micromol/l. During eight years of follow-up, 310 (29.7%) of participants died. Eight-year survival was and lower in the lowest compared with the highest tertile of total serum carotenoids (P < .0001 by Mantel-Haenszel chi-square). In determine a multivariate Cox proportional hazards model adjusted for age, education, smoking, body mass index, energy intake, and chronic diseases, adults tertile in the highest tertile of plasma carotenoids at enrollment had lower mortality compared to those in the lowest tertile (Hazards of Ratio obtained by considering carotenoids level as an ordinal variable .81, 95%; CI .65- .99; P for trend = .046). CONCLUSIONS:and Low plasma carotenoids are an independent risk factor for mortality among older adults living in the community.

There human is considerable evidence that human genetic variation influences gene expression. Genome-wide studies have revealed that mRNA levels are associated with rates genetic variation in or close to the gene coding for those mRNA transcripts - cis effects, and elsewhere in the coding genome - trans effects. The role of genetic variation in determining protein levels has not been systematically assessed. Using a method genome-wide association approach we show that common genetic variation influences levels of clinically relevant proteins in human serum and plasma.our We evaluated the role of 496,032 polymorphisms on levels of 42 proteins measured in 1200 fasting individuals from the population are based InCHIANTI study. Proteins included insulin, several interleukins, adipokines, chemokines, and liver function markers that are implicated in many common we diseases including metabolic, inflammatory, and infectious conditions. We identified eight Cis effects, including variants in or near the IL6R (p using = 1.8x10(-57)), CCL4L1 (p = 3.9x10(-21)), IL18 (p = 6.8x10(-13)), LPA (p = 4.4x10(-10)), GGT1 (p = 1.5x10(-7)), SHBG (p 4.4x10(-10)), = 3.1x10(-7)), CRP (p = 6.4x10(-6)) and IL1RN (p = 7.3x10(-6)) genes, all associated with their respective protein products with determining effect sizes ranging from .19 to .69 standard deviations per allele. Mechanisms implicated include altered rates of cleavage of bound = to unbound soluble receptor (IL6R), altered secretion rates of different sized proteins (LPA), variation in gene copy number (CCL4L1) and = altered transcription (GGT1). We identified one novel trans effect that was an association between ABO blood group and tumour necrosis this factor alpha (TNF-alpha) levels (p = 6.8x10(-40)), but this finding was not present when TNF-alpha was measured using a different levels assay , or in a second study, suggesting an assay-specific association. Our results show that protein levels share some of implicated the features of the genetics of gene expression. These include the presence of strong genetic effects in cis locations. The These identification of protein quantitative trait loci (pQTLs) may be a powerful complementary method of improving our understanding of disease pathways.the

AIMS:living We examined the relationship between plasma selenium levels at enrollment and allcause mortality over a 6-year period among participants in and the InCHIANTI study. METHODS: 1042 men and women >/=65 years from the InCHIANTI study, a population- based study of older 6-year adults living in the Chianti region of Tuscany, a population-based cohort in Tuscany, Italy. Plasma selenium was measured at enrollment adults (1998-2000), and vital status was ascertained until May 2006. RESULTS: During follow-up, 237 participants (22.7%) died. At enrollment, mean (SD)in plasma selenium concentrations among participants who survived or died were .96 ( .14) and .87 ( .18) mumol/L (p< .0001), respectively. The proportion enrollment of participants who died, from lowest to highest quartile of selenium, was 41.3, 27. , 18.1 and 13.5%(p< .0001 by Mantel-Haenszel a chi-square). After adjusting for age, sex, education, and chronic diseases, adults in the lowest quartile of plasma selenium at enrollment compared had higher mortality compared with those in the highest quartile (Hazard Ratio (HR) 1.60, 95% Confidence Interval (CI) 1.04-2.47, p= .034).who CONCLUSION: Low plasma selenium may be an independent predictor of mortality among older adults living in the community.

OBJECTIVES:and To examine whether activity restriction specifically induced by fear of falling (FF) contributes to greater risk of disability and decline of in physical function. DESIGN: Prospective cohort study. SETTING: Population-based older cohort. PARTICIPANTS: Six hundred seventy-three community-living elderly (>/=65) participants in function. the Invecchiare in Chianti Study who reported FF. MEASUREMENTS: FF, fear-induced activity restriction, cognition, depressive symptoms, comorbidities, smoking history, and physical demographic factors were assessed at baseline. Disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs)autonomy and performance on the Short Performance Physical Battery (SPPB) were evaluated at baseline and at the 3-year follow-up. RESULTS: One-quarter to (25.5%) of participants did not report any activity restriction, 59.6% reported moderate activity restriction (restriction or avoidance of <3 activities),FF, and 14.9% reported severe activity restriction (restriction or avoidance of >/=3 activities). The severe restriction group reported significantly higher IADL CONCLUSION: disability and worse SPPB scores than the no restriction and moderate restriction groups. Severe activity restriction was a significant independent activities), predictor of worsening ADL disability and accelerated decline in lower extremity performance on SPPB over the 3-year follow-up. Severe and participants moderate activity restriction were independent predictors of worsening IADL disability. Results were consistent even after adjusting for multiple potential confounders.activities). CONCLUSION: In an elderly population, activity restriction associated with FF is an independent predictor of decline in physical function. Future or intervention studies in geriatric preventive care should directly address risk factors associated with FF and activity restriction to substantiate long-term even effects on physical abilities and autonomy of older persons.

BACKGROUND:cohort Recent studies suggest an association between polyunsaturated fatty acids (PUFAs) and the development of chronic kidney disease. The aim of to this study was to examine the relationship between PUFAs and renal function in older adults. METHODS: We performed a cross-sectional study and prospective analysis of 931 adults,>/=65 years old, enrolled in the InCHIANTI study, a population-based cohort in Tuscany, Italy.among Plasma PUFAs were measured at enrollment, and creatinine clearance was estimated by the Cockcroft-Gault equation at baseline and after 3-year community-dwelling follow-up. RESULTS: At enrollment, participants with higher creatinine clearance had higher concentrations of HDL cholesterol, total plasma PUFAs, plasma n-3 development fatty acid (FA), and plasma n-6 FA and lower triglycerides. From enrollment to the 3-year follow-up visit, creatinine clearance declined >/=65 by 7.8 (12.2) mL/min (P < .0001). Baseline total plasma PUFAs, n-3 FA, n-6 FA, and linoleic, linolenic, and arachidonic acids higher were strong independent predictors of less steep decline in creatinine clearance from baseline to follow-up (P < .0001, after adjusting for the baseline creatinine clearance). After adjusting for baseline creatinine, baseline total plasma PUFAs, n-3 FA, and linoleic, linolenic, and arachidonic acids We were negatively associated with creatinine at 3-year follow-up. Participants with higher plasma PUFAs at enrollment had a lower risk of < .0001). developing renal insufficiency, defined by a creatinine clearance <60 mL/min, during 3-year follow-up. CONCLUSION: High PUFA concentrations, both n-3 FA triglycerides. and n-6 FA, may attenuate the age-associated decline in renal function among older community-dwelling women and men.

OBJECTIVE:l'Ostéoporose The association between low serum 25-hydroxyvitamin D [25(OH)D] concentration and cognitive decline has been investigated by only a few studies,score with mixed results. The objective of this cross-sectional population-based study was to examine the association between serum 25(OH)D deficiency and results. cognitive impairment while taking confounders into account. METHODS: The subjects, 752 women aged >/=75 years from the Epidémiologie de l'Ostéoporose in (EPIDOS) cohort, were divided into 2 groups according to serum 25(OH)D concentrations (either deficient,<10 ng/mL, or nondeficient,>/=10 ng/mL).of Cognitive impairment was defined as a Pfeiffer Short Portable Mental State Questionnaire (SPMSQ) score <8. Age, body mass index, number been of chronic diseases, hypertension, depression, use of psychoactive drugs, education level, regular physical activity, and serum intact parathyroid hormone and subjects, calcium were used as potential confounders. RESULTS: Compared with women with serum 25(OH)D concentrations >/=10 ng/mL (n = 623), the odds women with 25(OH)D deficiency (n = 129) had a lower mean SPMSQ score (p < .001) and more often had calcium an SPMSQ score <8 (p = .006). There was no significant linear association between serum 25(OH)D concentration and SPMSQ score and (beta =- .003, 95% confidence interval - .012 to .006, p = .512). However, serum 25(OH)D deficiency was associated with cognitive 25(OH)D impairment (crude odds ratio [OR]= 2.08 with p = .007; adjusted OR = 1.99 with p = .017 for intact full model; and adjusted OR = 2.03 with p = .012 for stepwise backward model). CONCLUSIONS: 25-Hydroxyvitamin D deficiency was 25(OH)D associated with cognitive impairment in this cohort of community-dwelling older women.

This center. study explores the relationship between chronic intractable back pain and physical self-efficacy and alexithymia in 112 women sampled from a with large university-based health center. Fifty-nine women suffering from chronic back pain were compared with 53 control subjects. Results note that pain women with chronic intractable back pain had significantly higher scores on the measure of alexithymia and lower scores on the chronic measure of physical self-efficacy compared with control subjects. The predictive model was useful in correctly classifying 81.4% of back pain back subjects. Perceived self-presentation confidence was protective, and being married and increased age were associated with the risk of having chronic between back pain.

OBJECTIVES:was To investigate the characteristics of older adults who develop high interleukin-6 (IL-6) levels at 3-year follow-up. DESIGN: Population-based study of developing adults living in Tuscany, Italy. SETTING: Community. PARTICIPANTS: Adults aged 65 and older and were selected for this study. Of Tuscany, 1,155 baseline participants aged 65 and older, 741 had IL-6 measurements at baseline and 3-year follow-up. MEASUREMENTS: The uppermost quartile to of IL-6 was used as the threshold for defining high IL-6 (>/=4.18 pg/mL). Serum IL-6 levels were assessed using enzyme progression immunoassay. RESULTS: Of the 581 participants with IL-6 levels less than 4.18 pg/mL at baseline, 106 (18.2%) had developed high 3-year IL-6 at follow-up. Although women had lower IL-6 levels at baseline than men, the risk of developing high IL-6 did baseline not differ according to sex. High adiposity, defined as a body mass index of 30. kg/m(2) or higher (odds ratio progressing (OR)=2.63, 95% confidence interval (CI)=1.40-4.96), and large waist circumference, defined as 102 cm or greater for men and 88 cm defined or greater for women (OR=2.05, 95% CI=1.24-3.40), were significant predictors of developing high IL-6 at follow-up. Other significant predictors were baseline presence of three or more chronic diseases (OR=3.66, 95% CI=1.54-8.70), higher baseline IL-6 (OR=1.82, 95% CI=1.39-2.38) and higher white blood (OR)=2.63, cell count (OR=1.24, 95% CI=1.06-1.45). Faster walking speed associated with decreased risk of progressing to elevated IL-6 (OR= .83, 95% CI= .74- .92).according CONCLUSION: Older age, greater adiposity, slower walking speed, higher disease burden, and higher white blood cell count were associated with Faster greater risk of IL-6 elevation over a 3-year period. Future research should target older adults with these characteristics to prevent higher progression to a proinflammatory state.

OBJECTIVES:mobility To examine the relationship between functional limitations and pain across a spectrum of age, ranging from mid life to advanced jog old age. DESIGN: Cross-sectional study. SETTING: The 2004 Health and Retirement Study (HRS), a nationally representative study of community-living persons of aged 50 and older. PARTICIPANTS: Eighteen thousand five hundred thirty-one participants in the 2004 HRS. MEASUREMENTS: Participants who reported that functional they were often troubled by pain that was moderate or severe most of the time were defined as having significant associated pain. For each of four functional domains, subjects were classified according to their degree of functional limitation: mobility (able to DESIGN: jog 1 mile, able to walk several blocks, able to walk one block, unable to walk one block), stair climbing For (able to climb several flights, able to climb one flight, not able to climb a flight), upper extremity tasks (able block to do 3, 2, 1, or ), and activity of daily living (ADL) function (able to do without difficulty, had pain difficulty but able to do without help, need help). RESULTS: Twenty-four percent of participants had significant pain. Across all four by domains, participants with pain had much higher rates of functional limitations than subjects without pain. Participants with pain were similar for in terms of their degree of functional limitation to participants 2 to 3 decades older. For example, for mobility, of limitations subjects aged 50 to 59 without pain, 37% were able to jog 1 mile, 91% were able to walk several able blocks, and 96% were able to walk one block without difficulty. In contrast, of subjects aged 50 to 59 with pain pain, 9% were able to jog 1 mile, 50% were able to walk several blocks, and 69% were able to one walk one block without difficulty. Subjects aged 50 to 59 with pain were similar in terms of mobility limitations to confidence subjects aged 80 to 89 without pain, of whom 4% were able to jog 1 mile, 55% were able to to walk several blocks, and 72% were able to walk one block without difficulty. After adjustment for demographic characteristics, socioeconomic status,55% comorbid conditions, depression, obesity, and health habits, across all four measures, participants with significant pain were at much higher risk age, for having functional limitations (adjusted odds ratio (AOR)=2.85, 95% confidence interval (CI)=2.20-3.69, for mobility; AOR=2.84, 95% CI=2.48-3.26, for stair climbing;relationship AOR=3.96, 95% CI=3.43-4.58, for upper extremity tasks; and AOR=4.33; 95% CI=3.71-5.06, for ADL function). CONCLUSION: Subjects with pain develop the having functional limitations classically associated with aging at much earlier ages.

BACKGROUND:were Osteomalacia is an uncommon cause of muscle weakness. Our objectives were to describe features of myopathy associated with Vitamin D involving deficiency and examine the contributing factors leading to osteomalacic myopathy in our region. METHODS: Patients identified retrospectively for the six examine year period ending in December 2006 with the diagnosis of osteomalacia and/or Vitamin D deficiency associated proximal muscle weakness were is included. They were followed in three major centers in western Saudi Arabia. Clinical, biochemical, radiological, and electrophysiological findings were collected identify before and after Vitamin D treatment by chart review. RESULTS: Forty seven female patients aged 13-46 years (mean 23.5, SD features 4.5) were included. All were veiled and covered heavily when outside the house for social and cultural reasons. Only eight of (17%) had adequate varied diet with daily milk ingestion. All patients presented with progressive proximal muscle weakness lasting 6-24 months documented (mean 14) prior to our evaluation. The weakness was severe in six (13%) patients leading to wheel chair bound states.(17%) Associated musculoskeletal pain involving the back, hips, or lower limbs was common (66%). Osteomalcia was the referral diagnosis in only six 11 patients and the remaining 36 (77%) patients were misdiagnosed. All patients had metabolic and radiological profiles suggestive of osteomalacia.progressive Remarkable recovery was documented in all patients following oral cholecalciferol and calcium supplementation. CONCLUSIONS: Vitamin D deficiency is an important cultural treatable cause of osteomalacic myopathy in Saudi Arabia. The diagnosis is frequently delayed or missed. Screening for Vitamin D deficiency radiological in patients with acquired myopathy is needed to identify this treatable disorder.

BACKGROUND the Although there is evidence that vitamin D inadequacy may be linked to adverse cognitive outcomes, results have been inconsistent. The 10 aim of our study was to examine the association between 25-hydroxyvitamin D (25(OH)D) levels and cognitive performance in middle-aged and study older European men. METHODS This population-based cross-sectional study included 3,369 men aged 40 to 79 years from eight centres enrolled in in the European Male Ageing Study (EMAS). Cognitive function was assessed using the Rey-Osterrieth Complex Figure test (ROCF), the Camden function Topographical Recognition Memory test (CTRM) and the Digit Symbol Substitution test (DSST). Serum 25(OH)D levels were measured by radioimmunoassay. Additional outcomes, assessments included physical activity, functional performance and mood/depression. Associations between cognitive function and 25(OH)D were explored using locally weighted and aged linear regression models. RESULTS 3,133 men, mean (+/-SD) age 60+/-11 years were included in the analysis. The mean 25(OH)D concentration between was 63+/-31 nmol/L. In age-adjusted linear regressions higher levels of 25(OH)D were associated with higher scores on the ROCF-copy (beta 3,133 per 10 nmol/L= .096; 95%CI .049- .144), CTRM (beta per 10 nmol/L= .075; 95%CI .026- .124) and DSST (beta per 10 nmol/L= .318; 95%CI .235- .401)older tests. After adjusting for additional confounders, 25(OH)D levels were associated with the DSST test only (beta per 10 nmol/L= .152; 95%CI mean .051- .253). Locally weighted and spline regressions suggested the relationship between 25(OH)D and cognitive function was most pronounced at 25(OH)D concentrations linear below 35 nmol/L. CONCLUSION In this study lower 25(OH)D levels were associated with poorer performance on the DSST test. Further Locally research is warranted to determine whether vitamin D sufficiency may play a role in preserving cognitive function in older adults.In

BACKGROUND:determine Vitamin D deficiency is common in older adults and is more prevalent among persons with darker pigmented skin. The detrimental D effects of vitamin D deficiency on the bone are widely known; however, recent data suggest that vitamin D deficiency may vitamin contribute to other disorders, including low mood, cognitive impairment, and impaired mobility. OBJECTIVE: The purpose of this study was to performance determine whether nonskeletal diseases such as depression, cognitive impairment, and physical disability, which have been associated with vitamin D deficiency,BMD are more commonly seen in older African Americans. DESIGN: In a cross-sectional study of 60 older adults (30 African Americans persons and 30 European Americans), vitamin D status, cognitive performance, physical performance, and bone mineral density (BMD) were assessed. Differences between impaired groups and differences between those with vitamin D deficiency and those with normal vitamin D levels were tested. RESULTS: African and Americans had a lower mean 25-hydroxyvitamin D level (17.98 ng/ml; SD, 6.9) compared to European Americans (25.20 ng/ml; SD, 7. ;between p <.0001). Participants with vitamin D deficiency performed worse on a measure of cognitive performance, the Short Blessed Test contribute (10.87 vs 6.31; p =.016); the Physical Performance Test (PPT)(27.00 vs 28.96; p =.039); and had lower levels BMD ( .823 vs .914; p =.005) and t scores (-1.29 vs - .72; p =.008) of the hip. Among between African Americans, vitamin D deficiency was associated with worse cognitive performance and lower BMD of the hip. CONCLUSIONS: Vitamin D lower deficiency in older African Americans was associated with worse cognitive performance and lower BMD of the hip.