Serum 25‐hydroxyvitamin D and cognitive decline in the very old: the Newcastle 85+ Study

Abstract

Background and purposeStudies investigating the association between 25-hydroxyvitamin D [25(OH)D] and cognition in the very old (85+) are lacking.MethodsCross-sectional (baseline) and prospective data (up to 3 years follow-up) from 775 participants in the Newcastle 85+ Study were analysed for global (measured by the Standardized Mini-Mental State Examination) and attention-specific (measured by the attention battery of the Cognitive Drug Research test) cognitive performance in relation to season-specific 25(OH)D quartiles.ResultsThose in the lowest and highest season-specific 25(OH)D quartiles had an increased risk of impaired prevalent (1.66, 95% confidence interval 1.06–2.60, P = 0.03; 1.62, 95% confidence interval 1.02–2.59, P = 0.04, respectively) but not incident global cognitive functioning or decline in functioning compared with those in the middle quartiles adjusted for sociodemographic, health and lifestyle confounders. Random effects models showed that participants belonging to the lowest and highest 25(OH)D quartiles, compared with those in the middle quartiles, had overall slower (log-transformed) attention reaction times for Choice Reaction Time (lowest, β = 0.023, P = 0.01; highest, β = 0.021, P = 0.02), Digit Vigilance Task (lowest, β = 0.009, P = 0.05; highest, β = 0.01, P = 0.02) and Power of Attention (lowest, β = 0.017, P = 0.02; highest, β = 0.022, P = 0.002) and greater Reaction Time Variability (lowest, β = 0.021, P = 0.02; highest, β = 0.02, P = 0.03). The increased risk of worse global cognition and attention amongst those in the highest quartile was not observed in non-users of vitamin D supplements/medication.ConclusionLow and high season-specific 25(OH)D quartiles were associated with prevalent cognitive impairment and poorer overall performance in attention-specific tasks over 3 years in the very old, but not with global cognitive decline or incident impairment.

Vitamin D Levels in Lebanese Patients with Schizophrenia: A Case-Control Study

“…Increasing the behavioral and cognitive function would increase outdoor activities and exposure to sunlight [1,48]. Different studies had reported that insufficiency or deficiency of vitamin D is associated with cognitive impairment [1,23,[53][54][55][56]. Vitamin D deficiency can be associated with muscle weakness that might lead to cognitive impairment [57].…”

What do we know about the nutritional status of the very old? Insights from three cohorts of advanced age from the UK and New Zealand

“…The median (interquartile range) plasma vitamin B 12 was 232 (170-324). Roughly 17 % (n 125) were below the threshold of 148 pM/l for plasma vitamin B 12 and, 15·0 % (n 110) were above 15 µM/l for homocysteine while being deficient for cobalamin (N Mendonҫa et al, unpublished results). The NDNS rolling programme estimated that 5·9 % were below 150 pM/l of serum vitamin B 12 (66) .…”

“…for those who are housebound) and low vitamin D status contributes to the risk of mortality (11) , cognitive decline (12) , several age-related diseases and low mood and depression (13) . Vitamin B 12 uptake from the gut is impaired in those with atrophic gastritis (a common problem in older people (14) and vitamin B 12 deficiency can damage the nervous system leading to balance disturbances and, possibly, more rapid cognitive decline. However, a recent intervention study (B-PROOF study) reported no effect of a combined supplement of folic acid and vitamin B 12 on cognitive outcomes among older (mean age 74·1 years) Dutch participants (15) .…”

“…Vitamin and mineral intakes in EPIC-Oxford were generally higher than in any other study but the choice of dietary assessment method and participants' age have to be taken into account. The very old adults participating in the Dutch National Food Consumption Survey had higher intakes of vitamin B 12 and calcium than others (except EPIC-Oxford) which reflects the high dairy products consumption (36) . In the Newcastle 85+ study, < 40 and 25 % of participants met the reference nutrient intake for all minerals (except sodium) and all vitamins (except vitamin B 12 ), respectively, μg/d (41) .…”

“…Erythrocyte folate and plasma vitamin B 12 were analysed in 752 and 753 participants, respectively in the Newcastle 85+ study at baseline. The median (interquartile range) erythrocyte folate was 863 nM/l (451-1287) and only 3·6 % (n 26) were below the threshold of 340 nM/l (N Mendonҫa et al, unpublished results).…”