Division of Geriatrics and Gerontology, School of Medicine, Federal University of São Paulo, Unifesp, Rua Professor Francisco de Castro, 105, São Paulo, SP, 04020-050, Brazil.
Information Systems, School of Arts, Sciences and Humanities, USP, São Paulo, Brazil.
Int Urol Nephrol. 2019 Apr;51(4):713-721. doi: 10.1007/s11255-019-02081-w. Epub 2019 Jan 30.
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.
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.
Every 1 year of life, there was reduction of about 10% chance of adequate performance in functional capacity. Each 1 ml/min/m 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.
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.
本研究旨在评估估算肾小球滤过率（eGFR）下降和血清 25（OH）D 与 80 岁及以上老年人身体和精神功能能力之间的关系。
我们从多个方面评估了功能能力：老年抑郁量表（GDS）、日常生活活动能力量表（IADL）、精神状态简易量表（MMSE）、言语流畅性测验（VF）、握力和 5 次从椅子上坐起和站起的时间，结合肌酐和半胱氨酸蛋白酶抑制剂 C 计算的 eGFR 以及 25（OH）D 水平，对 205 名无症状和居住在社区的独立老年人进行了横断面研究。
每增加 1 岁，功能能力的适当表现机会就会降低约 10%。eGFR 每增加 1ml/min/ml，IADL 适当表现的机会就会增加 2%。我们没有发现 eGFR 与认知之间的关联。血清 25（OH）D 水平在 15.00 至 22.29ng/ml 之间，与血清维生素 D 水平较低相比，增加了 VF、IADL、握力和从椅子上坐起和站起的表现机会。
随着年龄的增长，肾功能下降会影响老年人在社区中独立生活的能力，但我们没有观察到认知和身体表现特定领域的影响。与 eGFR 测量相比，血清 25（OH）D 水平较低似乎是功能下降风险增加的标志物，而与 eGFR 测量相比，血清 25（OH）D 水平较低似乎是功能下降风险增加的标志物。
