1. In this study, vitamin D3 and omega-3 fatty acid supplementation in heathy, older adults without vitamin D3 deficiency did not prevent changes in frailty over time.

2. Furthermore, older participants had greater increase in frailty over time.

Evidence Rating Level: 1 (Excellent) 

Frailty is a syndrome of decreased physiologic reserve and is experienced by up to half of adults 85 years or older. As the aging population increases in the world, identifying ways to combat frailty is essential. The Mediterranean diet has been shown to reduce frailty. However, whether taking supplements of vitamin D3 and omega-3 fatty acid, which are abundant in the Mediterranean diet, would have similar benefits is not well known.

This study was ancillary to a randomized control trial of 25,057 men (over the age of 50) and women (over the age of 55) across all 50 states of the United States of America. Patients with cancer or cardiovascular diseases were excluded. Patients were randomized to receive daily supplementation with either vitamin D3 + omega-3 fatty acid, vitamin D3 alone, omega-3 fatty acid alone, or 2 placebos for 5 years. The primary outcome was change in frailty score over time, which was measured via annual Rockwood frailty index assessing function, cognition, mood, and comorbidities.

Study results demonstrated that neither vitamin D3 nor omega-3 fatty acid supplementation modified change in frailty score compared to placebo. Controlling for sex, baseline age, or other randomized intervention did not change results. Furthermore, incident frailty was similar between the two groups throughout the duration of the study period. However, this study was limited by several confounders. First, most participants were not vitamin D3 deficient and regularly consumed fish, which may mask the effect of subsequent supplementation. Second, the mean frailty score was lower in the study population than the general population, which may limit the generalizability of these results. Nonetheless, these results suggest that supplements alone should not be a therapeutic strategy for preventing frailty.

Click to read the study in JAMA Network Open

Image: PD

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