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Liu J, Roccati E, Chen Y, Zhu Z, Wang W, He M, Shang X. Seasonal Variations in Vitamin D Levels and the Incident Dementia Among Older Adults Aged ≥60 Years in the UK Biobank. J Alzheimers Dis Rep 2024; 8:411-422. [PMID: 38549631 PMCID: PMC10977452 DOI: 10.3233/adr-230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/17/2024] [Indexed: 05/16/2024] Open
Abstract
Background Limited knowledge exists regarding the association between dementia incidence and vitamin D insufficiency/deficiency across seasons. Objective This study aimed to evaluate the impact of seasonal serum vitamin D (25(OH)D) levels on dementia and its subtypes, considering potential modifiers. Methods We analyzed 193,003 individuals aged 60-73 at baseline (2006-2010) from the UK Biobank cohort, with follow-up until 2018. 25(OH)D were measured at baseline, and incident dementia cases were identified through hospital records, death certificates, and self-reports. Results Out of 1,874 documented all-cause dementia cases, the median follow-up duration was 8.9 years. Linear and nonlinear associations between 25(OH)D and dementia incidence across seasons were observed. In multivariable-adjusted analysis, 25(OH)D deficiency was associated with a 1.5-fold (95% CIs: 1.2-2.0), 2.2-fold (1.5-3.0), 2.0-fold (1.5-2.7), and 1.7-fold (1.3-2.3) increased incidence of all-cause dementia in spring, summer, autumn, and winter, respectively. Adjusting for seasonal variations, 25(OH)D insufficiency and deficiency were associated with a 1.3-fold (1.1-1.4) and 1.8-fold (1.6-2.2) increased dementia incidence, respectively. This association remained significant across subgroups, including baseline age, gender, and education levels. Furthermore, 25(OH)D deficiency was associated with a 1.4-fold (1.1-1.8) and 1.5-fold (1.1-2.0) higher incidence of Alzheimer's disease and vascular dementia, respectively. These associations remained significant across all subgroups. Conclusions 25(OH)D deficiency is associated with an increased incidence of dementia and its subtypes throughout the year.
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Affiliation(s)
- Jiahao Liu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Eddy Roccati
- Wicking Dementia Research and Education Centre, University of Tasmania, TAS, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Yutong Chen
- Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
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Shea MK, Barger K, Dawson-Hughes B, Leurgans SE, Fu X, James BD, Holland TM, Agarwal P, Wang J, Matuszek G, Heger NE, Schneider JA, Booth SL. Brain vitamin D forms, cognitive decline, and neuropathology in community-dwelling older adults. Alzheimers Dement 2023; 19:2389-2396. [PMID: 36479814 PMCID: PMC10244481 DOI: 10.1002/alz.12836] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/01/2022] [Accepted: 09/13/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Vitamin D purportedly protects against cognitive decline and dementia based on observational data using circulating 25-hydroxyvitamin D (25(OH)D). Little is known about vitamin D in the human brain and the association with dementia or neuropathology. METHODS Decedents of the Rush Memory and Aging Project (n = 290) had vitamin D concentrations measured in four brain regions. Associations with cognitive and neuropathological outcomes were estimated using linear and logistic regression. RESULTS The main form of vitamin D in all brain regions measured was 25(OH)D3 . Higher brain 25(OH)D3 concentrations were associated with a 25% to 33% lower odds of dementia or mild cognitive impairment (MCI) at the last visit before death (all P ≤ .031). However, brain 25(OH)D concentrations were not associated with any post-mortem neuropathology outcome studied. DISCUSSION Higher brain 25(OH)D3 concentrations were associated with better cognitive function prior to death. Additional research is needed to clarify the specific mechanisms underlying this potentially protective relationship.
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Affiliation(s)
- M. Kyla Shea
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston MA 02111
| | - Kathryn Barger
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston MA 02111
| | - Bess Dawson-Hughes
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston MA 02111
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University, 1750 West Harrison Street, Suite 1000, Chicago, Illinois 60612
- Department of Neurological Sciences, Rush University, Chicago IL, 60612
| | - Xueyan Fu
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston MA 02111
| | - Bryan D. James
- Rush Alzheimer’s Disease Center, Rush University, 1750 West Harrison Street, Suite 1000, Chicago, Illinois 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago IL, 60612
| | - Thomas M. Holland
- Department of Internal Medicine, Rush University Medical Center, Chicago IL, 60612
| | - Puja Agarwal
- Department of Neurological Sciences, Rush University, Chicago IL, 60612
| | - Jifan Wang
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston MA 02111
| | - Gregory Matuszek
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston MA 02111
| | - Nicholas E. Heger
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston MA 02111
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University, 1750 West Harrison Street, Suite 1000, Chicago, Illinois 60612
- Department of Neurological Sciences, Rush University, Chicago IL, 60612
| | - Sarah L. Booth
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston MA 02111
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Feng J, Wang Q, Zhang Y. Ideal vitamin D and handgrip strength counteracts the risk effect of APOE genotype on dementia: a population-based longitudinal study. J Transl Med 2023; 21:355. [PMID: 37246226 DOI: 10.1186/s12967-023-04195-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/14/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Higher vitamin D concentrations and grip strength contribute to lower individual-level risk of dementia, while apolipoprotein 4 (APOE e4) genotype carries increases dementia risk, but whether combination of ideal vitamin D and grip strength counteracts the risk effect of dementia related to APOE e4 genotype remains unclear. We aimed to investigate the interactions between vitamin D/grip strength and APOE e4 genotype and their association with dementia. METHODS The UK Biobank cohort comprised 165,688 dementia-free participants (aged at least 60 years) for the dementia analysis. Dementia was ascertained using hospital inpatient, mortality, and self-reported data until 2021. Vitamin D and grip strength were collected at baseline and divided into tertiles. APOE genotype was coded as APOE e4 non-carries and APOE e4 carries. Data were analyzed using Cox proportional hazard models and restricted cubic regression splines, with adjusted for known confounders. RESULTS Over the follow-up (median: 12.0 years), 3917 participants developed dementia. In women and men, respectively, compared with to the lowest tertile of vitamin D, the HRs (95% CIs) of dementia were lower in the middle [0.86 (0.76-0.97)/0.80 (0.72-0.90)] and the highest tertile [0.81 (0.72-0.90)/0.73 (0.66-0.81)]. Tertiles of grip strength showed similar patterns. In women and men, respectively, participants who had both highest tertile of vitamin D and grip strength was associated with a lower risk of dementia compared to those with both lowest tertile of these two exposures among APOE e4 genotype carries (HR = 0.56, 95% CI 0.42-0.76, and HR = 0.48, 95% CI 0.36-0.64) and APOE e4 genotype non-carries (HR = 0.56, 95% CI 0.38-0.81, and HR = 0.34, 95% CI 0.24-0.47). There were significant additive interactions between lower vitamin D/grip strength and APOE e4 genotype on dementia among women and men. CONCLUSIONS Higher vitamin D and grip strength were associated with a lower risk of dementia, and seemed to halve the adverse effects of APOE e4 genotype on dementia. Our findings suggested that vitamin D and grip strength may be imperative for estimating the risks of dementia, especially among APOE e4 genotype carries.
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Affiliation(s)
- Jiangtao Feng
- Department of Orthopedics, Tianjin NanKai Hospital, Changjiang Road 6, Tianjin, 300100, China
- Department of Orthopedics, Integrated Chinese and Western Medicine Hospital, Tianjin University, Changjiang Road 6, Tianjin, 300100, China
| | - Qi Wang
- Department of Orthopedics, Tianjin NanKai Hospital, Changjiang Road 6, Tianjin, 300100, China
- Department of Orthopedics, Integrated Chinese and Western Medicine Hospital, Tianjin University, Changjiang Road 6, Tianjin, 300100, China
| | - Yuan Zhang
- Department of Orthopedics, Tianjin NanKai Hospital, Changjiang Road 6, Tianjin, 300100, China.
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
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Dhana K, Barnes LL, Agarwal P, Liu X, Dhana A, Desai P, Aggarwal N, Evans DA, Rajan KB. Vitamin D intake and cognitive decline in Blacks and Whites: The role of diet and supplements. Alzheimers Dement 2023; 19:1135-1142. [PMID: 35867354 PMCID: PMC9867781 DOI: 10.1002/alz.12729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/12/2022] [Accepted: 06/01/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION To determine the role of vitamin D intake on cognitive decline among Blacks and Whites. METHODS Using data from the population-based Chicago Health and Aging Project, we studied 2061 Blacks and 1329 Whites with dietary vitamin D data and cognitive testing over 12 years of follow-up. Multivariable linear mixed-effects models were used to determine the association of vitamin D intake with cognitive decline. RESULTS Vitamin D intake, particularly dietary vitamin D, was associated with a slower rate of decline in cognitive function among Blacks. In Blacks, comparing individuals in the lowest tertile of dietary intake, those in the highest tertile had a slower cognitive decline of 0.017 units/year (95% confidence interval 0.006, 0.027), independently of supplementation use. In Whites, vitamin D intake was not associated with cognitive decline. DISCUSSION Dietary vitamin D may help to slow the decline in cognitive abilities among Blacks as they age.
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Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Lisa L Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Department of Neurology, Rush University Medical Center, Chicago, IL
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Neelum Aggarwal
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Department of Neurology, Rush University Medical Center, Chicago, IL
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
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Flores AC, Jensen GL, Mitchell DC, Na M, Wood GC, Still CD, Gao X. Prospective Study of Diet Quality and the Risk of Dementia in the Oldest Old. Nutrients 2023; 15:nu15051282. [PMID: 36904280 PMCID: PMC10005581 DOI: 10.3390/nu15051282] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
This study examined the associations between overall diet quality and the risk of dementia in a rural cohort among the oldest old. Included in this prospective cohort study were 2232 participants aged ≥ 80 years and dementia-free at the baseline according to the Geisinger Rural Aging Study (GRAS), a longitudinal cohort in rural Pennsylvania. In 2009, diet quality was assessed by a validated dietary screening tool (DST). Incident cases of dementia during 2009-2021 were identified using diagnosis codes. This approach was validated by a review of electronic health records. Associations between diet quality scores and the incidence of dementia were estimated using the Cox proportional hazards models, adjusted for potential confounders. Across a mean of 6.90 years of follow-up, we identified 408 incident cases of all-cause dementia. Having a higher diet quality was not significantly associated with a lower risk for incidents of all-cause dementia (adjusted HR for the highest compared with the lowest tertile: 1.01, 95% CI: 0.79, 1.29, P-trend = 0.95). Similarly, we did not observe a significant association between diet quality and altered risks of Alzheimer's disease and other forms of dementia. Overall, having a higher diet quality was not significantly associated with a lower risk of dementia among the oldest old during the full follow-up.
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Affiliation(s)
- Ashley C. Flores
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
| | - Gordon L. Jensen
- Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Diane C. Mitchell
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
| | - G. Craig Wood
- Obesity Institute, Geisinger Health System, Danville, PA 17822, USA
| | | | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
- School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200437, China
- Correspondence:
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Chen P, Li X, Yu Y, Zhang J, Zhang Y, Li C, Li J, Li K. Administration Time and Dietary Patterns Modified the Effect of Inulin on CUMS-Induced Anxiety and Depression. Mol Nutr Food Res 2023; 67:e2200566. [PMID: 36811233 DOI: 10.1002/mnfr.202200566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/14/2022] [Indexed: 02/24/2023]
Abstract
SCOPE Prebiotics exert anxiolytic and antidepressant effects through the microbiota-gut-brain axis in animal models. However, the influence of prebiotic administration time and dietary pattern on stress-induced anxiety and depression is unclear. In this study, whether administration time can modify the effect of inulin on mental disorders within normal and high-fat diets are investigated. METHODS AND RESULTS Mice subjected to chronic unpredicted mild stress (CUMS) are administered with inulin in the morning (7:30-8:00 am) or evening (7:30-8:00 pm) for 12 weeks. Behavior, intestinal microbiome, cecal short-chain fatty acids, neuroinflammatory responses, and neurotransmitters are measured. A high-fat diet aggravated neuroinflammation and is more likely to induce anxiety and depression-like behavior (p < 0.05). Morning inulin treatment improves the exploratory behavior and sucrose preference better (p < 0.05). Both inulin treatments decrease the neuroinflammatory response (p < 0.05), with a more evident trend for the evening administration. Furthermore, morning administration tends to affect the brain-derived neurotrophic factor and neurotransmitters. CONCLUSION Administration time and dietary patterns seem to modify the effect of inulin on anxiety and depression. These results provide a basis for assessing the interaction of administration time and dietary patterns, providing guidance for the precise regulation of dietary prebiotics in neuropsychiatric disorders.
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Affiliation(s)
- Ping Chen
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China
| | - Xiaofang Li
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China
| | - Ying Yu
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China
| | - Jiaming Zhang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China
| | - Yingying Zhang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China
| | - Chunmei Li
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China.,Key Laboratory of Environment Correlative Food Science, Ministry of Education, Huazhong Agricultural University, Wuhan, 430070, China
| | - Jing Li
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China.,Key Laboratory of Environment Correlative Food Science, Ministry of Education, Huazhong Agricultural University, Wuhan, 430070, China
| | - Kaikai Li
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China.,Key Laboratory of Environment Correlative Food Science, Ministry of Education, Huazhong Agricultural University, Wuhan, 430070, China
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Revisiting the Role of Vitamins and Minerals in Alzheimer's Disease. Antioxidants (Basel) 2023; 12:antiox12020415. [PMID: 36829974 PMCID: PMC9952129 DOI: 10.3390/antiox12020415] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Alzheimer's disease (AD) is the most common type of dementia that affects millions of individuals worldwide. It is an irreversible neurodegenerative disorder that is characterized by memory loss, impaired learning and thinking, and difficulty in performing regular daily activities. Despite nearly two decades of collective efforts to develop novel medications that can prevent or halt the disease progression, we remain faced with only a few options with limited effectiveness. There has been a recent growth of interest in the role of nutrition in brain health as we begin to gain a better understanding of what and how nutrients affect hormonal and neural actions that not only can lead to typical cardiovascular or metabolic diseases but also an array of neurological and psychiatric disorders. Vitamins and minerals, also known as micronutrients, are elements that are indispensable for functions including nutrient metabolism, immune surveillance, cell development, neurotransmission, and antioxidant and anti-inflammatory properties. In this review, we provide an overview on some of the most common vitamins and minerals and discuss what current studies have revealed on the link between these essential micronutrients and cognitive performance or AD.
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Beversdorf DQ, Crosby HW, Shenker JI. Complementary and Alternative Medicine Approaches in Alzheimer Disease and Other Neurocognitive Disorders. MISSOURI MEDICINE 2023; 120:70-78. [PMID: 36860601 PMCID: PMC9970340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
As our population ages, there is interest in delaying or intervening in cognitive decline. While newer agents are under development, agents in mainstream use do not impact the course of diseases that cause cognitive decline. This increases interest in alternative strategies. Even as we welcome possible new disease-modifying agents, they are likely to remain costly. Herein, we review the evidence behind other complementary and alternative strategies for cognitive enhancement and prevention of cognitive decline.
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Affiliation(s)
- David Q Beversdorf
- Departments of Neurology, Radiology, and Psychological Sciences, and is the William and Nancy Thompson Endowed Chair in Radiology, , University of Missouri-Columbia School of Medicine, Columbia, Missouri
| | - Haley W Crosby
- Fourth-year medical student at the School of Medicine, , University of Missouri-Columbia School of Medicine, Columbia, Missouri
| | - Joel I Shenker
- Department of Neurology, University of Missouri-Columbia School of Medicine, Columbia, Missouri
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Cen Q, Zhu J, Zhou L, Yu W, Wu X, Liu Y, Ma G, Luo L, Lin X. Comparison of the safety and efficacy of low fluence Q-switched 1064-nm and conventional Q-Switched 755-nm lasers in the treatment of café-au-lait macules: A prospective self-controlled trial. Lasers Surg Med 2022; 54:1051-1059. [PMID: 36084202 DOI: 10.1002/lsm.23594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/07/2022] [Accepted: 08/14/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Conventional high fluence Q-switched (HFQS) Alexandrite 755-nm are widely used in clinical café-au-lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q-switched (LFQS) Nd: YAG 1064-nm lasers. OBJECTIVE To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs. METHODS Within 3 months, 20 patients underwent prospective self-controlled split-lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow-up visit. Patient and physician preferences for laser selection were also recorded. RESULTS The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82-2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment. CONCLUSIONS The efficacy difference between the LFQS 1064-nm laser and HFQS 755-nm laser in treating CALMs in a 3-month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.
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Affiliation(s)
- Qingqing Cen
- Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China.,Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jiafang Zhu
- Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Lucia Zhou
- Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Wenxin Yu
- Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xianglei Wu
- Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ying Liu
- Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Gang Ma
- Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China.,Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Lan Luo
- Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China.,Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
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10
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Li YX, Li JC, Tian M, Zheng MY, Zhang LP, Zhang JL, Yu F, Li YZ, Zhang QH. Efficacy and safety of Dengyinnaotong Capsule in patients with Cognitive impairment caused by cerebral Small Vessel Disease: study protocol of a multicenter, randomized, open-label, controlled trial (De-CSVD trial). Trials 2022; 23:676. [PMID: 35978350 PMCID: PMC9386924 DOI: 10.1186/s13063-022-06646-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 08/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background Cerebral small vessel disease (CSVD) is a common syndrome in the older population, with a prevalence ranging from 5% in subjects aged 50 years to almost 100% in those aged 90 years and older. It is regarded to be a major cause of vascular cognitive impairment. Existing prevention and treatment approaches have not yet shown ideal clinical outcomes. Dengyinnaotong Capsule has shown great potential for improving cognitive function. This trial (De-CSVD trial) is designed to investigate the efficacy and safety of Dengyinnaotong Capsule on cognitive function in patients with CSVD . Methods This multicenter, randomized, open-label, controlled trial is planned to recruit at least 270 patients with mild cognitive impairment related to CSVD in 25 centers in China. Recruitment started on 10 May 2021 and is foreseen to end on 31 December 2022. The final follow-up of participants will be completed by the end of March 2023. Participants will be randomized in a ratio of 1:1 to the experimental group (routine basic treatment plus Dengyinnaotong Capsule) or the control group (routine basic treatment). The primary outcome is the change in the Montreal Cognitive Assessment score from baseline to week 12. Secondary outcomes are changes in Shape Trail Test, Activities of Daily Living, Geriatric Depression Scale, and Dizziness Handicap Inventory score from baseline to week 12, new vascular events, and the changes in serum level of homocysteine, high-sensitivity C-reactive protein, and D-dimer from baseline to week 4 and 12, respectively. The exploratory outcome is the changes in the Tinetti performance-oriented mobility assessment score from baseline to week 12. Safety assessment is performed by monitoring vital signs, general biochemical examinations, 12-lead electrocardiogram examinations, and incidence of cardiovascular and cerebrovascular ischemia or bleeding events. Visits will be performed at week 0 (baseline, pre-randomization), week 4, and week 12 in the treatment period (post-randomization). Discussion This trial is the first to investigate the efficacy and safety of Dengyinnaotong Capsule on cognitive impairment in patients with CSVD. The findings of this study might provide convincing evidence regarding the efficacy of Dengyinnaotong Capsule in patients with mild cognitive impairment related to CSVD. Trial registration Chinese Clinical Trial Registry ChiCTR2100045831. Registered on 25 April 2021.
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Affiliation(s)
- Yan-Xia Li
- Department of Neurology, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Jin-Cun Li
- Department of Neurology, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Min Tian
- Department of Neurology, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Mao-Yong Zheng
- Department of Neurology, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Li-Ping Zhang
- Department of Neurology, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Jin-Lu Zhang
- Department of Neurology, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Feng Yu
- Department of Administration, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Yi-Zhao Li
- Department of Neurology, Jinan Fanggan Rehabilitation Hospital, Jinan, Shandong, China
| | - Qing-Hua Zhang
- Department of Neurology, Shandong Second Provincial General Hospital, Shandong University, Jinan, Shandong, China.
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11
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Angiogenin Levels and Their Association with Cardiometabolic Indices Following Vitamin D Status Correction in Saudi Adults. BIOLOGY 2022; 11:biology11020286. [PMID: 35205153 PMCID: PMC8868634 DOI: 10.3390/biology11020286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 11/23/2022]
Abstract
Simple Summary Angiogenin (ANG) is a small 123 amino acid protein which in normal growth is associated with formation of new blood vessels in a process called angiogenesis; however, the abnormal levels of this protein in blood has been associated with diseases such as cancer, neurological disorders, and cardiovascular diseases. Vitamin D deficiency and elevated levels of blood lipids have also been associated with many diseases including cardiovascular diseases. In this study, the investigators tried to evaluate the relationship between the circulating levels of ANG, vitamin D, and lipids. The model used was vitamin D supplementation of deficient Saudi adults in order to find the effect of vitamin D correction on circulating levels of ANG and blood lipids. With vitamin D supplementation, modest but non-significant elevation in ANG was observed, as well as significant increase in apolipoproteins CIII and E and significant decrease in apo B. In addition, the correlation between circulating levels of ANG and apolipoproteins especially apo E observed in this study are interesting and should be investigated more as both are linked with neurologic disorders like Alzheimer’s and Parkinson’s diseases. Abstract Angiogenin (ANG), a multifunctional protein known to induce blood vessel formation, is a potential biomarker for cardiovascular diseases; however, whether it is affected by vitamin D supplementation is not known. This interventional study in vitamin D-deficient Saudi adults was designed to investigate it. A total of 100 vitamin D-deficient Saudi adults aged 30–50 years were randomly selected to undergo 6-month vitamin D supplementation. Circulating levels of fasting glucose, lipids, vitamin D, apolipoproteins (AI, AII, B, CI, CII, CIII, E, and H), and ANG were measured using commercially available assays at baseline and after six months. Overall, vitamin D levels increased significantly post intervention. With this, levels of apo-CIII and apo-E significantly increased (p-values of 0.001 and 0.009, respectively) with a significant parallel decrease in apo-B (p = 0.003). ANG levels were significantly positively associated with most apolipoproteins and inversely correlated with HDL-cholesterol. Post intervention, the changes in ANG levels were positively correlated with apo-E (r = 0.32; p < 0.01 in all subjects and r = 0.40; p < 0.05 in males). Vitamin D supplementation may modestly affect ANG levels. The association observed between ANG and apo-E is worthy of further investigation since both biomarkers have been linked to neurodegenerative disorders.
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12
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Factors Influencing Alzheimer's Disease Risk: Whether and How They are Related to the APOE Genotype. Neurosci Bull 2022; 38:809-819. [PMID: 35149974 PMCID: PMC9276873 DOI: 10.1007/s12264-021-00814-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/25/2021] [Indexed: 11/21/2022] Open
Abstract
Alzheimer's disease (AD) is the most prevalent neurodegenerative disease featuring progressive cognitive impairment. Although the etiology of late-onset AD remains unclear, the close association of AD with apolipoprotein E (APOE), a gene that mainly regulates lipid metabolism, has been firmly established and may shed light on the exploration of AD pathogenesis and therapy. However, various confounding factors interfere with the APOE-related AD risk, raising questions about our comprehension of the clinical findings concerning APOE. In this review, we summarize the most debated factors interacting with the APOE genotype and AD pathogenesis, depict the extent to which these factors relate to APOE-dependent AD risk, and discuss the possible underlying mechanisms.
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13
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Shang X, Hodge AM, Hill E, Zhu Z, He M. Associations of Dietary Pattern and Sleep Duration with Cognitive Decline in Community-Dwelling Older Adults: A Seven-Year Follow-Up Cohort Study. J Alzheimers Dis 2021; 82:1559-1571. [PMID: 34180411 DOI: 10.3233/jad-201329] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND A few studies have linked dietary patterns and sleep to cognitive decline. OBJECTIVE To examine the independent and joint associations of dietary patterns and sleep with cognitive decline. METHODS Our analysis included 2,307 participants aged 55- 89 years at baseline from the China Health and Nutrition Survey. Dietary intake was assessed using weighing methods in combination with 24 h dietary recalls for three consecutive days. Exploratory factor analysis was applied to identify major dietary factors. Cognition was assessed in 1997, 2000, 2004, 2006, and 2015. RESULTS Five dietary patterns were identified: dairy-fruits-fast foods, grains-vegetables-pork, plant-based food, beans-mushroom, and beverages-nuts patterns. Beans-mushroom pattern and sleep duration of 8 h/day were defined as healthy habits. There was a positive association between the beans-mushroom pattern and change in the global cognitive Z-score over seven years (β (95% CI) for quintile 5 versus quintile 1:0.17 (0.05, 0.30)). Compared to individuals with sleep duration of 8 h/day, those with sleep duration of≤5 h/day (β (95% CI): - 0.23 (- 0.45, - 0.00)) or > 10 h/day (- 0.52 (- 0.73, - 0.32)) had a greater decrease in global cognitive Z-score. Compared to individuals with no healthy patterns, those with a healthy dietary pattern only (β (95% CI): 0.18 (0.08, 0.28)), healthy sleep pattern only (0.13 (0.04, 0.23), and both healthy dietary and sleep patterns (0.19 (0.08, 0.31)) had a relative increase in global cognitive Z-score. CONCLUSION Our findings highlight the importance of involving both diet and sleep as intervention priorities for the potential prevention of cognitive decline.
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Affiliation(s)
- Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Edward Hill
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.,Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mingguang He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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14
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Kim H, Sereika SM, Albert SM, Bender CM, Lingler JH. Do perceptions of cognitive changes matter in self-management behaviors among persons with mild cognitive impairment? THE GERONTOLOGIST 2021; 62:577-588. [PMID: 34447996 DOI: 10.1093/geront/gnab129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This secondary analysis examined 1) the association between illness perceptions (perceived understanding and cause of mild cognitive impairment [MCI]) and self-management behaviors for cognitive health, and 2) whether sociodemographic and clinical factors moderate such relationships among persons with MCI. RESEARCH DESIGN AND METHODS We conducted a cross-sectional study of 85 participants using baseline data from the Return of Amyloid Imaging Scan Results (RAISR) Study. The coherence and causality subscales of the Revised Illness Perceptions Questionnaires were used. Self-management behaviors (dietary changes, physical activity, mental activities, dietary supplements) were assessed using the Risk Evaluation and Education for ALzheimer's disease health behavior measure. Sociodemographic and clinical information was extracted from patients' medical records. We performed hierarchical linear regression and binary logistic regression. RESULTS We found no main effects for illness perceptions and self-management of cognitive health. Interaction effects were detected, including: 1) coherence and age on the total number of self-management behaviors (b = 0.01, p = 0.04) and on physical activity (p = 0.04, OR = 1.02, 95% CI = [1.00, 1.03]), 2) causality and age on dietary supplements (p = 0.03, OR = 1.31, 95% CI = [1.02, 1.67]), and 3) causality and education on mental activities (p = 0.02, OR = 0.44, 95% CI = [0.22, 0.88]). IMPLICATION AND DISCUSSIONS Findings suggest that age and education moderate the relationship between illness perceptions and self-management behaviors. Healthcare professionals should consider subjective perceptions about MCI in light of sociodemographic and clinical factors when discussing cognitive health self-management.
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Affiliation(s)
- Hyejin Kim
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA
| | - Susan M Sereika
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Steven M Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Catherine M Bender
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Jennifer H Lingler
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.,Alzheimer's Disease Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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15
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Botelho J, Leira Y, Viana J, Machado V, Lyra P, Aldrey JM, Pías-Peleteiro JM, Blanco J, Sobrino T, Mendes JJ. The Role of Inflammatory Diet and Vitamin D on the Link between Periodontitis and Cognitive Function: A Mediation Analysis in Older Adults. Nutrients 2021; 13:924. [PMID: 33809193 PMCID: PMC8001166 DOI: 10.3390/nu13030924] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/13/2022] Open
Abstract
Patients suffering from periodontitis are at a higher risk of developing cognitive dysfunction. However, the mediation effect of an inflammatory diet and serum vitamin D levels in this link is unclear. In total, 2062 participants aged 60 years or older with complete periodontal diagnosis and cognitive tests from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 were enrolled. The Consortium to Establish a Registry for Alzheimer's disease (CERAD) word learning subtest (WLT) and CERAD delayed recall test (DRT), the animal fluency test (AFT) and the digit symbol substitution test (DSST) was used. Dietary inflammatory index (DII) was computed via nutrition datasets. Mediation analysis tested the effects of DII and vitamin D levels in the association of mean probing depth (PD) and attachment loss (AL) in all four cognitive tests. Periodontitis patients obtained worse cognitive test scores than periodontally healthy individuals. DII was negatively associated with CERAD-WLT, CERAD-DRT, AFT and DSST, and was estimated to mediate between 9.2% and 36.4% of the total association between periodontitis with cognitive dysfunction (p < 0.05). Vitamin D showed a weak association between CERAD-DRT, AFT and DSST and was estimated to between 8.1% and 73.2% of the association between periodontitis and cognitive dysfunction (p < 0.05). The association between periodontitis and impaired cognitive function seems to be mediated both by a proinflammatory dietary load and vitamin D deficiency. Future studies should further explore these mediators in the periodontitis-cognitive decline link.
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Affiliation(s)
- João Botelho
- Periodontology Department, Instituto Universitário Egas Moniz, 2829-511 Almada, Portugal;
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal; (J.V.); (P.L.); (J.J.M.)
| | - Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London WC1E 6DE, UK;
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
| | - João Viana
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal; (J.V.); (P.L.); (J.J.M.)
| | - Vanessa Machado
- Periodontology Department, Instituto Universitário Egas Moniz, 2829-511 Almada, Portugal;
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal; (J.V.); (P.L.); (J.J.M.)
| | - Patrícia Lyra
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal; (J.V.); (P.L.); (J.J.M.)
| | - José Manuel Aldrey
- Dementia Unit, Department of Neurology, Clinical University Hospital, 15706 Santiago de Compostela, Spain; (J.M.A.); (J.M.P.-P.)
| | - Juan Manuel Pías-Peleteiro
- Dementia Unit, Department of Neurology, Clinical University Hospital, 15706 Santiago de Compostela, Spain; (J.M.A.); (J.M.P.-P.)
| | - Juan Blanco
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
| | - José João Mendes
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal; (J.V.); (P.L.); (J.J.M.)
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16
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Panza F, La Montagna M, Lampignano L, Zupo R, Bortone I, Castellana F, Sardone R, Borraccino L, Dibello V, Resta E, Altamura M, Daniele A, Lozupone M. Vitamin D in the development and progression of alzheimer's disease: implications for clinical management. Expert Rev Neurother 2021; 21:287-301. [PMID: 33406925 DOI: 10.1080/14737175.2021.1873768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Although the pathophysiological bases of Alzheimer's disease (AD) remain incompletely understood and disease-modifying therapies are not available, intervention on modifiable risk factors is warranted. Research on nutrition and dietary components is challenging and controversies still persist about the role of micro- and macronutrients and health outcomes in dementia. Importantly, results of preclinical investigations have shown that vitamin D triggers different neural pathways that may be protective against these neurodegenerative mechanisms, including the deposition of amyloid plaques, inflammatory processes, neurofibrillary degeneration, glutamatergic excitotoxicity, excessive intraneuronal calcium influx, and oxidative stress, although its relationship with AD still needs to be fully understood. AREAS COVERED The authors analyzed the recent evidence about the effects of vitamin D insufficiency on AD and the role of supplementation. EXPERT OPINION Both insufficient (25-49.9 ng/ml) and deficient levels (<25 ng/ml) of vitamin D may contribute to an increased susceptibility to AD. However, further well-designed prospective studies are needed for a better understanding of the involvement of low vitamin D concentrations in the AD natural history. Randomized clinical trials will also be necessary to address the issue of causality and determine whether vitamin D supplementation may be effective for the prevention or treatment of AD.
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Affiliation(s)
- Francesco Panza
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Maddalena La Montagna
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luisa Lampignano
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Roberta Zupo
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Ilaria Bortone
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Fabio Castellana
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Rodolfo Sardone
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Luisa Borraccino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vittorio Dibello
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy.,Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, The Netherlands
| | - Emanuela Resta
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari Aldo Moro, Bari, Italy.,Translational Medicine & Management of Health Systems, University of Foggia, Foggia, Italy
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy.,Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
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