The Effect of High Dose Vitamin D3 on Physical Performance in Frail Older Adults. A Feasibility Study
Bibliographic record
Abstract
BACKGROUND: Vitamin D deficiency is ubiquitous in frailty but the effectiveness of vitamin D supplementation to improve outcomes in frail individuals is unclear. It has been postulated that higher than the current recommended doses (800 IU/day) may be needed to achieve a neuromuscular effect in frail individuals. OBJECTIVES: 1) determine if 4000 IU per day of vitamin D3 is safe for frail older adults; and 2) establish the efficacy of this dose to improve physical performance outcomes in this population. DESIGN: Open-label, feasibility study. SETTING: Community retirement centre. PARTICIPANTS: 40 older adults with frail or pre-frail characteristics. INTERVENTION: 4000 IU of vitamin D3 and 1200 mcg of calcium carbonate daily for four months. MEASUREMENTS: Physical performance (grip strength, gait speed and short physical performance battery score), cognitive health and vitamin D and iPTH serum levels before and after the intervention. RESULTS: Frail individuals improved short physical performance battery score (1.19, p = 0.005), fast gait speed (4.65, p = 0.066) and vitamin D levels (7.81, p = 0.011). Only frail females made a significant improvement in grip strength (1.92, p = 0.003). Stratifying the sample by baseline vitamin D levels revealed that participants with vitamin D insufficiency (≤ 75 nmol/L) significantly improved short physical performance battery score (1.06, p = 0.04), fast gait speed (6.28, p = 0.004) and vitamin D levels (25.73, p = <0.0001). Pre-frail individuals, as well as those with sufficient vitamin D levels (> 75 nmol/L) made no significant improvement in any outcome. CONCLUSIONS: Vitamin D supplementation using 4000 IU/daily is safe and has a modest beneficial effect on physical performance for frail individuals and those with insufficient vitamin D levels. Participants with vitamin D insufficiency (≤ 75 nmol/L) showed greater benefits. Our feasibility study provides results to help calculate effect size for a future RCT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".