MON-751 Low Serum 25-Hydroxyvitamin D as a Risk Factor for Frailty in Older Men: A Korean Nationwide Study

Abstract Disclosure: B. Kim: None. J. Lee: None. J. Ha: None. K. Baek: None. Context: Frailty is a clinical syndrome defined by a gradual deterioration in physiological function, reflecting reduced resilience and increased vulnerability to adverse health outcomes. Low serum 25-hydroxyvitamin D (25[OH]D) levels have been identified as a significant factor associated with an increased risk of frailty, suggesting as a target for preventive strategies. Objective: This study aimed to examine the association between serum 25(OH)D levels and frailty status in older Korean adults using data from a nationally representative data. Design/Setting/Participants: This cross-sectional study included 6,589 participants aged 65 years or older from the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2012). Frailty was assessed using a deficit accumulation frailty index (FI) constructed from 36 items across physical, cognitive, psychological, and social domains. Participants were categorized as non-frail (FI ≤ 0.15), pre-frail (0.15 < FI ≤ 0.25), or frail (FI > 0.25). Serum 25(OH)D levels were stratified into quartiles (Q1 ≤ 15.7 ng/mL to Q4 > 25.3 ng/mL) and sufficiency categories (deficient <12 ng/mL, insufficient 12-20 ng/mL, sufficient ≥20 ng/mL). Results: Low serum 25(OH)D quartile were associated with higher frailty indices in older men (P =0.033). Men in the lowest quartile of serum 25(OH)D (≤15.7 ng/mL) had significantly higher risk of frailty (Odd ratio, OR = 1.71, 95% CI: 1.18-2.48) compared to those in the highest quartile (>25.3 ng/mL), which was used as the reference. When categorized by serum 25(OH)D status, men with deficiency showed significantly higher frailty indices compared to those with sufficient levels of 25(OH)D (P < 0.001) and had a 1.98-fold higher risk of frailty (95% CI: 1.27-3.10) in multivariate analysis. However, no significant association was observed between serum 25(OH)D levels and pre-frail status across quartiles or vitamin D sufficiency categories. In women, serum 25(OH)D levels were not significantly associated with frailty indices, pre-frail, or frail status. Conclusion: Low serum 25(OH)D is independently associated with a higher risk of frailty in older men. Monitoring and implementing appropriate vitamin D supplementation as strategies to prevent frailty and its associated adverse outcomes. Presentation: Monday, July 14, 2025