Vitamin D Status and Rates of Cognitive Decline in a Multiethnic Cohort of Older Adults

Abstract

Vitamin D (VitD) deficiency is associated with cognitive decline and risk of dementia. We assessed associations between VitD and cognitive decline in an ethnically diverse cohort of older adults (N=382; age 76±7y; 41% White, 26% Hispanic, 29% African‐American, 4% other). Serum 25‐hydroxyvitamin D (25OHD) was measured by immunoassay. VitD status was defined as deficiency, <12 ng/ml; insufficiency, 12‐20 ng/ml; adequacy, >20 ng/ml. Cognitive function was assessed at baseline and yearly using the Spanish English Neuropsychological Assessment Scales (mean follow‐up: 4.8±2.5y). Baseline diagnoses were dementia, 17%; mild cognitive impairment (MCI), 33%; cognitively normal, 50%. Mean 25OHD was 19.2±11.7 ng/ml; 26% were deficient, 35% were insufficient. 25OHD was lower in demented subjects compared with MCI and cognitively normal (16.2±9.4 vs 20.0±10.3 and 19.7±13.1 ng/ml; p=0.07). Controlling for age, sex, education, ethnicity, BMI, season, vascular risk, and apoE4, rates of cognitive decline were greater in VitD deficient and insufficient subjects compared with those with adequate VitD status for episodic memory and executive function (p<0.03). Associations of VitD with declines in semantic memory and visuospatial ability were not statistically significant. Exclusion of demented subjects did not affect the associations of VitD with cognitive decline. Low VitD status is associated with accelerated rates of decline in domains of cognitive function in ethnically diverse older adults. It remains to be determined if VitD supplements slow cognitive decline. NIH AG010129‐21

Vitamin D in amyotrophic lateral sclerosis

“…In other neurological diseases, low vitamin D levels have been found to be associated with greater disease severity and with a worse prognosis Ji, 2015a. Shen andJi, 2015b;Burton and Costello, 2015;Miller et al, 2015;Balion et al, 2012;Mowry et al;. This interest is partially due to convincing data, in vitro or in animal models, showing a positive role of vitamin D in the development of the nervous system, in neuroprotection, and in the modulation of neuroinflammation (Gianforcaro and Hamadeh 2012;Solomon et al, 2011).…”

“…Recent studies have evaluated the neuroprotective role of vitamin D in many neurodegenerative diseases (Shen and Ji, 2015a;Shen and Ji, 2015b;Burton and Costello, 2015;Miller et al, 2015;Balden et al, 2012). ALS patients show low levels of vitamin D, probably due to different factors: age, the presence of chronic disease, physical inactivity, reduced sun exposure, and malnutrition (Sato et al, 1997;Holick et al, 1989).…”

Vitamin D: Way More Important in Critical Care Than We May Have Recognized

“…These substantial cognitive losses, especially in episodic and semantic memory and executive function (problem-solving, following directions, reasoning) related to dementia and Alzheimer disease, were independent of baseline cognitive ability, race, ethnicity, or other risk factors. 59 Some of the neurosteroid actions of vitamin D that may account for its notable effects on cognition include clearance of amyloid-peptide and antioxidant, antiinflammatory effects that may protect against the neurodegeneration associated with Alzheimer disease. Some researchers consider supplemental vitamin D as crucial to slow, prevent, or improve neurocognitive decline.…”

Vitamin D Düzeyi Düşük Erişkin Kadınlarda Bilişsel Fonksiyonların Standardize Mini Mental Test ve Montreal Bilişsel Değerlendirme Ölçeği ile Değerlendirilmesi

“…Ancak çoğu çalışmada, vitamin D ve bilişsel fonksiyon ilişkisi yaşlı popülasyonda araştırılmıştır. Özellikle ileri yaşlarda düşük vitamin D seviyelerinin, demansla ilişkisi oldukça yüksek olan hafıza ve yönetici fonksiyonlarda gerilemeye neden olduğu gösterilmiştir (10)(11)(12). Ancak bu bilginin daha erken yaşlarda doğruluğu ile ilgili veriler yetersizdir (2,13,14).…”