Vitamin K status and physical decline in older adults-The Longitudinal Aging Study Amsterdam

OBJECTIVE: We examined the association between vitamin K status and physical functioning over 13 years in the Longitudinal Aging Study Amsterdam.

STUDY DESIGN: Longitudinal cohort study of 633 community-dwelling adults from the Longitudinal Aging Study Amsterdam (LASA) aged 55-65 years (54% women).

MAIN OUTCOME MEASURES: At baseline (2002-2003), plasma desphospho-uncarboxylated matrix Gla protein (dp-ucMGP) was measured with a sandwich ELISA as a marker of vitamin K status. The outcome measures handgrip strength, calf circumference, self-reported functional limitations and functional performance were obtained at baseline and four follow-up examinations. We used generalized estimating equations to determine the relationship between dp-ucMGP tertiles and the various outcome measurements after adjusting for potential confounders. The lowest dp-ucMGP tertile reflects a high vitamin K status and was the reference.

RESULTS: Mean dp-ucMGP was 376 ± 233 pmol/L and mean follow-up was 11.1 years. Participants showed a decline in the outcome measures over time. Compared with the lowest tertile, the highest dp-ucMGP tertile had: lower handgrip strength, 1.1 kg (95% confidence interval (-2.1, -0.1; P-trend <0.001); smaller calf circumference, -0.5 cm (-0.9 -0.1; P-trend = 0.018); and, only among women, a 0.7-point poorer functional performance score (-1.1, -0.3; P-interaction = 0.002). Dp-ucMGP was not related to self-reported functional limitations. No interaction effects between time and dp-ucMGP were observed.

CONCLUSIONS: Low vitamin K status was associated with lower handgrip strength, smaller calf circumference, and, in women only, with poorer functional performance score. A low vitamin K status was however not related to the 13-year decline in these measures.