Assessments

All study participants were asked to attend one visit at baseline, where the following data were collected.

Socio-demographic data such as age, gender, ethnicity, marital status, education, number of prescribed drugs, smoker status, and alcohol consumption were collected during the visit. Charlson Comorbidity Index was used to determine the comorbidity level^31,32, and Malnutrition Universal Screening Test (MUST) was used to determine the risk of malnutrition³³.

Physical Activity Scale for the Elderly (PASE)^34,35 was used to determine physical activity level and Modified Barthel Index (MBI)³⁶ was used to measure functional independence for ten activities of daily living.

For anthropometry and body composition measurements, standing height was measured without shoes by using a stadiometer to the nearest millimeter (Avamech B1000), and body weight and composition were measured to the nearest 0.1 kg using a bioelectrical impedance analysis (BIA) machine (Tanita MC-780). BIA was used to estimate muscle mass, fat mass, and bone mass. Mid upper arm circumference was measured at mid-point of the acromion and olecranon, and calf circumference was measured at the largest part of the calf. Both were measured to the nearest 0.1 cm.

Serum 25-hydroxyvitamin D levels were measured using immunochemistry analyzer COBAS e801 and vitamin D cut-off values were based on the definition described by Holick³⁷.

Healthcare utilization data on hospitalization and length of stay was collected using medical records and questionnaires if the former is unavailable.