Geriatrics

The Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin have shown in the largest study to date that lower levels of specific dietary vitamins and antioxidants are associated with frailty. But Frailty is a common chronic syndrome which affects up to 25% of adults over 65 years and over half of adults over 80. Frailty is characterised by an overall decline in physical function and a loss of ability to bounce back after experiencing a stressful event such as infection, a fall or surgery.

Ageing is challenging state

It is associate with poor health, disability and death. The TILDA study examined the association of vitamin B12, folate, vitamin D, lutein and zeaxanthin levels with frailty. The B vitamins (B12 and folate); are important for several cellular processes throughout the body including DNA repair and energy metabolism. Vitamin D is essential for bone metabolism; muscle strength and mood. Lutein and zeaxanthin have antioxidant and anti-inflammatory properties important in eye health and brain health. Low levels of all of these vitamins and antioxidants is common among Irish adults.

In this new research lower levels of lutein; zeaxanthin, and vitamin D were consistently associate with not only frailty but also earlier stages of ‘pre-frailty’; (a subclinical precursor of frailty). Low levels of B vitamins are associate with pre-frailty. Furthermore; the accumulation of micronutrient insufficiencies having low levels of more than one micronutrient is progressively associate with severity stages of frailty. This data raises the question of the role of dietary supplementation and contributes to the ongoing policy discussions regarding fortification.

Role of dietary supplementation

Lead author of the study and Senior Research Fellow at TILDA, Dr. Aisling O’Halloran, said: “We have presented evidence in the largest study to date that lower levels of specific vitamins and antioxidants and having low levels of more than one micronutrient; is consistently and progressively associated with the most commonly used methods for measuring frailty. Our data suggest that low micronutrient status may act as an easily modified marker and intervention target for frailty among adults aged 50 years and over”.

Principal Investigator of TILDA, Professor Rose-Anne Kenny said: “Frailty occurs when a number of systems in the body lose reserve capacity and therefore the ability to ‘bounce back’ after even trivial illnesses. Therefore It is an important and challenging state; commonly associated with ageing but also common in patients of any age who have major surgery; cancer treatments and severe infections. The hall mark of frailty is muscle weakness.

If it is recognised in its early stages, it can be reversed. However; the longer it is present, the more difficult is it to ‘bounce back’ and generalised weakness and fatigue become progressively worse. This research suggests new potential treatments for a common and important condition.”