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Older people with reduced muscle function often had reduced levels of calcidiol serum concentration. Low levels of calcidiol were not associated with signs of general undernutrition, such as low body mass, or with reduced arm-muscle circumference or triceps skinfold thickness. This finding may suggest a physiological role for calcidiol in muscle function. Reduced muscle strength increased disability in our older subjects, which may be improved by vitamin D supplementation in vitamin D-deficient subjects.

In this prospective study of elderly people, nutritional status (body mass index, triceps skinfold thickness, arm-muscle circumference, and serum albumin) was assessed in a group of recently hospitalized (< 48 h) patients (n = 311), and compared with a home-living group (n = 106). Undernutrition was present in 52.9% of males and 60.6% of females by the time of admission to the hospital. Further, 65% of the males and 69% of the females had an insufficient energy intake the month before hospitalization [males < 8372 kJ (2000 kcal) and females < 7116 kJ (1700 kcal)]. Intake of vitamins and trace elements below two-thirds of the US recommended dietary allowances was more common in the hospital group. This group was more often unable to buy food and cook dinner, had more chewing problems, and had reduced appetite for food. Reduced nutrient and energy intakes may increase the occurrence of undernutrition, with increased risk for hospitalization in vulnerable groups as a consequence.

Malnutrition is underdiagnosed and undertreated. The consequences of this are likely to be deleterious to health.