Vitamin K Status and Mobility Limitation and Disability in Older Adults: The Health, Aging, and Body Composition Study

Abstract

Vitamin K has been implicated in chronic diseases associated with increased risk for mobility disability, such as osteoarthritis and cardiovascular disease. However, the association between vitamin K status and mobility disability is unknown. Therefore, we examined the association between vitamin K status and incident mobility disability in the Health, Aging, and Body Composition Study. Plasma phylloquinone (vitamin K1) was categorized as <0.5, 0.5–<1.0 and ≥1.0 nmol/L ( n = 1,323, 48% male). Plasma ucMGP, which increases when vitamin K status is low, was measured in 716 participants and categorized into tertiles. Mobility limitation and disability, defined as two consecutive semiannual reports of having any or a lot of difficulty walking a one-fourth mile or climbing 10 steps without resting, were assessed over a median 6–10 years of follow-up. Multivariate Cox proportional hazard models were used to evaluate the association between vitamin K status and incident mobility limitation and disability. Participants with plasma phylloquinone less than 0.5 nmol/L were more likely to develop mobility limitation and disability compared to those with at least 1.0 nmol/L (adjusted HR (95% CI) mobility limitation: 1.27 (1.05–1.53); disability: 1.34 (1.01–1.76)). After further adjustment for knee pain, the associations were partially attenuated (HR (95% CI) mobility limitation: 1.20 (0.99–1.45); disability: 1.26 (0.96–1.67)). Plasma ucMGP was not associated with incident mobility limitation, but was nonlinearly associated with incident mobility disability (HR (95% CI), compared to tertile 1: tertile 2 = 1.64 (1.19–2.27), tertile 3 = 1.17 (0.83–1.66), fully adjusted). Our results suggest vitamin K may be involved in the disablement process in older age. Future studies are needed to confirm our findings and clarify the underlying mechanism.