Using Activities of Daily Living Assessments to Measure the Effectiveness of Vitamin D Supplements in Elderly Long-Stay Patients

Corless, D.; Ellis, Margaret; Dawson, Erica L.; Fråser, F C; Evans, Stephen; Perry, James D.; Silver, C.P.; Reisner, Colin; Beer, M.; Boucher, Barbara J.; Cohen, R. D.

doi:10.1177/030802268705000208

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…While many studies have demonstrated an association between vitamin D level and cognition in the general population, the few clinical trials that have been done fail to show improvement with supplementation (110)(111)(112)(113)(114)(115)(116)(117)(118)(119). Even less is known about the effects of vitamin D on cognition in Parkinson's disease, and study findings have been inconsistent ( Table 1).…”

Section: Non-motor Symptoms Cognitionmentioning

confidence: 99%

A Review of the Relationship Between Vitamin D and Parkinson Disease Symptoms

Fullard

Duda

2020

Front. Neurol.

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Vitamin D is a fat-soluble secosteroid that exerts its effects by binding to the vitamin D receptor (VDR), through which it directly and indirectly modulates the expression of hundreds to thousands of genes. While originally known for its role in regulating calcium homeostasis and metabolism, vitamin D is now associated with many other health conditions, including Parkinson's disease (PD). A high prevalence of vitamin D deficiency has been noted in PD for at least the past two decades. These findings, along with the discovery that the VDR and 1α-hydroxylase, the enzyme that converts vitamin D to its active form, are highly expressed in the substantia nigra, led to the hypothesis that inadequate levels of circulating vitamin D may lead to dysfunction or cell death within the substantia nigra. Studies investigating the relationship between vitamin D status and PD, however, have been inconsistent. Two prospective studies examined the association between mid-life vitamin D levels and risk of PD and produced conflicting results-one demonstrated an increased risk for PD with lower mid-life vitamin D levels, and the other showed no association between vitamin D and PD risk. One of the most consistent findings in the literature is the inverse association between serum vitamin D level and motor symptom severity in cross-sectional studies. While these data suggest that vitamin D may modify the disease, another likely explanation is confounding due to limited mobility. Fall risk has been associated with vitamin D in PD, but more study is needed to determine if supplementation decreases falls, which has been demonstrated in the general population. The association between vitamin D and non-motor symptoms is less clear. There is some evidence that vitamin D is associated with verbal fluency and verbal memory in PD. Studies in PD have also shown associations between vitamin D status and mood, orthostatic hypotension and olfactory impairment in PD. While more research is needed, given the numerous potential benefits and limited risks, vitamin D level assessment in PD patients and supplementation for those with deficiency and insufficiency seems justified.

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Section: Non-motor Symptoms Cognitionmentioning

confidence: 99%

A Review of the Relationship Between Vitamin D and Parkinson Disease Symptoms

Fullard

Duda

2020

Front. Neurol.

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“…The intervention in 2 of the RCTs was a supplement containing various nutrients in addition to vitamin D 33,59 and only 1 study treated with vitamin D alone. 58 In this study, long-stay patients with baseline 25(OH)D Ͻ40 nmol/L were treated with 9,000 IU vitamin D 2 for 8 -40 weeks or placebo (lactose tablets). No significant difference for the single cognitive measure (mental assessment score) was found between groups, but the number of participants was extremely small (n ϭ 82).…”

mentioning

confidence: 99%

Vitamin D, cognition, and dementia

Balion

Griffith²,

Strifler³

et al. 2012

Neurology

400

345

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Objective: To examine the association between cognitive function and dementia with vitamin D concentration in adults.Methods: Five databases were searched for English-language studies up to August 2010, and included all study designs with a comparative group. Cognitive function or impairment was defined by tests of global or domain-specific cognitive performance and dementia was diagnosed according to recognized criteria. A vitamin D measurement was required. Two authors independently extracted data and assessed study quality using predefined criteria. The Q statistic and I 2 methods were used to test for heterogeneity. We conducted meta-analyses using random effects models for the weighted mean difference (WMD) and Hedge's g. Results:Thirty-seven studies were included; 8 contained data allowing mean Mini-Mental State

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“…However, they have significant limitations, including weak observational methods (case–control) and limited adjustment of confounding factors 45 , 46 . The results from interventional studies are also conflicting, and these studies are limited by dose/type of vitamin D supplement and duration of follow-up 47 – 49 …”

Section: Discussionmentioning

confidence: 99%

“…45,46 The results from interventional studies are also conflicting, and these studies are limited by dose/type of vitamin D supplement and duration of follow-up. [47][48][49] Based on the systematic evaluation of the previous literature in the field, there may be an association between vitamin D status and dementia and cognitive impairment. However, little is known about the function of vitamin D in relation to different cognitive domains.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Quality assessment of systematic reviews of vitamin D, cognition and dementia

et al. 2018

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BackgroundThere is conflicting evidence regarding the association of vitamin D with cognition performance and dementia.AimsWe aimed to summarise the evidence on the association of vitamin D with cognitive performance, dementia and Alzheimer disease through a qualitative assessment of available systematic reviews and meta-analyses.MethodWe conducted an overview of the systematic reviews of all study types with or without meta-analyses on vitamin D and either Alzheimer disease, dementia or cognitive performance up to June 2017.ResultsEleven systematic reviews were identified, nine of which were meta-analyses with substantial heterogeneity, differing statistical methods, variable methodological quality and quality of data abstraction. A Measurement Tool to Assess Systematic Reviews checklist scores ranged from 4 to 10 out of 11, with seven reviews of ‘moderate’ and four of ‘high’ methodological quality. Out of six meta-analyses on the association between low serum concentration of 25-hydroxyvitamin D and risk of dementia, five showed a positive association. Results of meta-analyses on the association between low serum concentration of 25-hydroxyvitamin D and memory function tests showed conflicting results.ConclusionsThis systematic evaluation of available systematic reviews provided a clearer understanding of the potential link between low serum vitamin D concentrations and dementia. This evaluation also showed that the quality of the available evidence is not optimal because of both the low methodological quality of the reviews and low quality of the original studies. Interpretation of these systematic reviews should therefore be made with care.Declaration of interestNone.

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Using Activities of Daily Living Assessments to Measure the Effectiveness of Vitamin D Supplements in Elderly Long-Stay Patients

Cited by 9 publications

References 4 publications

A Review of the Relationship Between Vitamin D and Parkinson Disease Symptoms

A Review of the Relationship Between Vitamin D and Parkinson Disease Symptoms

Vitamin D, cognition, and dementia

Quality assessment of systematic reviews of vitamin D, cognition and dementia

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