Introduction: Considerable amounts of vitamin D are found in the brain and the vitamin D receptor is widely distributed throughout various brain regions. The effects of vitamin D on the regulation of genes involved in neuroprotection and neurotropism or neuronal regeneration have been described. There is a high prevalence of vitamin D deficiency or insufficiency among the elderly. The aim of this article is to review the relationship between vitamin D and cognition. We have attempted to answer three questions: Is there a physiological rationale that allows us to conclude that vitamin D has cognitively relevant effects? Is hypovitaminosis D associated with cognitive impairment? Does vitamin D supplementation have any effect on cognitive impairment or dementia? Development: A descriptive review has been conducted on the research that we have considered to be the most relevant published in the last decade: cross-sectional, prospective, and retrospective studies, and randomized placebo-controlled trials have been included. Conclusions:Preclinical studies show wide proof of concept that vitamin D may play a relevant role in cognitive functions. There is no consensus on the association of hypovitaminosis D and cognitive impairment, although most studies have found such an association. There is also no conclusive scientific evidence on beneficial effects of vitamin D supplementation on cognitive impairment, although the positive evidence available -mainly with cholecalciferol or vitamin D3 as preferred vitamin D form-is leading many authors and some clinicians to recommend it in usual practice. on vitamin D supplementation in this context and points out
Background: Polyethylene glycol (PEG) is an osmotic laxative considered as pharmacological first line choice for the treatment of chronic functional constipation and fecal impaction. Addition of electrolytes to PEG is a relevant clinical advantage since can minimize plasma electrolyte loss, improve safety, and even enhance the laxative effect. Bimotil ® with PEG-3350 and electrolytes (PEG-ELS) is a newly developed medicinal product with 2 different strengths: 13.7 g for adolescents, adults, and the elderly; and 6.9 g for children. Since the palatability of PEG-based laxatives with electrolytes is challenging, and relevant to improve acceptability and adherence (warranting therapeutic compliance) an acceptability comparative study versus Movicol ® at adult and pediatric strengths has been conducted. Methods: At strengths for adolescents, adults and the elderly, an ad hoc questionnaire with 3 sub-questionnaires (demographics, organoleptic and comparative preference) was designed. Organoleptic sub-questionnaire assessed acceptability and rates of taste attributes of sweet, salty and intensity flavor; and comparative sub-questionnaire included key forced overall preference, increasing willingness to take the product, and preference for repeated use items. At strengths for children, comparative key forced overall, and repeated use preference were assessed. Medicinal products were blindly presented to properly instructed subjects. The low amount of administered product made the occurrence of adverse effects very unlikely; anyway, a safety certificate was prepared. Results:In the adult sub-study (n=80), Bimotil ® 13.7 g and Movicol ® 13.8 g were compared with relevant statistically significant differences favoring Bimotil ® 13.7 g in key forced overall preference (76.3% vs. 23.8%, p < 0.05), acceptability rate (1-9) (5.75 vs. 4.84, p < 0.05), willingness to multitaking the product rate (1-9) (6.35 vs. 4.75, p < 0.05), and preference for repeated use (76.3% vs. 23.8%, p < 0.05). Moreover, Movicol ® 13.8 g was negatively valued in the 3-taste attributes. In the children sub-study (n=60), Bimotil ® Infantil 6.9 g was significantly better than Movicol ® Pediatrico Sabor Neutro 6.9 g in forced overall preference (65.0% vs. 35.0%, p < 0.05) and preference for repeated use (68.3% vs. 31.7%, p < 0.05).Conclusions: Bimotil ® has shown relevant advantages in palatability and acceptability in adults and children, in comparison with Movicol ® 13.8 g and Movicol ® Pediatrico Sabor Neutro, respectively.
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