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Maghbooli Z, Shirvani A, Moghadasi AN, Varzandi T, Hamtaei Ghashti S, Sahraian MA. Investigating the effects of 25-hydroxyvitamin D3 on clinical outcomes in multiple sclerosis patients: A randomized, double-blind clinical trial- a pilot study. Mult Scler Relat Disord 2024; 87:105673. [PMID: 38759424 DOI: 10.1016/j.msard.2024.105673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/03/2024] [Accepted: 05/05/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND The primary objective of this clinical trial was to assess whether administrating oral calcifediol (25(OH)D3) could enhance the clinical outcomes of patients diagnosed with multiple sclerosis. METHODS This clinical trial was designed as a randomized, double-blind, two-arm study, with 25 participants receiving daily 50 μg of calcifediol and 25 people receiving daily 50 μg of cholecalciferol. The primary outcomes were serum levels of 25(OH)D3, number of relapses, changes in Kurtzke Expanded Disability Status Scale (EDSS), the 25-foot walk, and cognitive function. RESULTS At the end of the trial, delta serum concentrations of 25(OH)D3 were 85.32±40.94 ng/ml in the calcifediol group compared to 13.72±11.56 ng/ml in the cholecalciferol group; 84 % of the calcifediol group and none of the cholecalciferol group had circulating 25(OH)D3 concentrations exceeding 70 ng/ml. While both groups showed an overall trend towards improved cognitive function at the end of the study, the calcifediol group exhibited greater improvements in most cognitive tests. However, the trial had no significant beneficial effects on MS relapse, EDSS score, quality of life, or fatigue in either group, the calcifediol or cholecalciferol. CONCLUSIONS The trial shows that calcifediol is more effective in rapidly increasing 25(OH)D3 levels in MS patients compared to cholecalciferol when administrated at a similar dosage.
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Affiliation(s)
- Zhila Maghbooli
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Shirvani
- Department of Medicine, Section of Endocrinology, Nutrition, Diabetes and Weight Management, Boston University Medical Center, Boston, Massachusetts, USA.
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tarlan Varzandi
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Hamtaei Ghashti
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Shu C, Zheng C, Du X, Luo D. Exploring the role of vitamin D in cognitive function: mediation by depression with diabetes modulation in older U.S. adults, a NHANES weighted analysis. Front Nutr 2024; 11:1356071. [PMID: 38895660 PMCID: PMC11183290 DOI: 10.3389/fnut.2024.1356071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Background The relationship between vitamin D levels, depressive symptoms, and cognitive function has yet to be definitively understood in the elderly, particularly when considering the impact of chronic diseases. This study focuses on how depression mediates the impact of 25-hydroxyvitamin D3 (25(OH)D3) on cognitive performance in older U.S. adults. Methods We analyzed data from 2,745 elderly individuals extracted from the NHANES 2011-2014 cycles, applying weighted processing to account for the complex multi-stage sampling design characteristic of NHANES data. Utilizing weighted data for covariate and model selection, we conducted mediation analyses on both the overall population and subgroup data. Significant mediation pathways were validated using a stratified weighted bootstrap approach. For significant subgroup pathways, we explored interactive mechanisms through interactive mediation analysis. Results Mediation analyses, thoroughly accounting for the impact of chronic conditions, revealed significant pathways in both the weighted overall population and the weighted diabetes subgroup. After 1,000 stratified weighted bootstrap replications, the proportion of mediation effects were 10.6% [0.040, 0.268] and 20.9% [0.075, 0.663], respectively. Interactive mediation analysis for diabetes indicated that the interaction between diabetes and depression was not significant in the direct pathway (estimates = 0.050, p = 0.113) but was significant in the mediation pathway, yielding the largest effect size compared to other covariates (estimates = 0.981, p < 0.001). Conclusion This study highlights the mediating role of depression in the relationship between vitamin D levels and cognitive function in the elderly, particularly emphasizing diabetes as a key moderator. Our findings suggest targeted interventions addressing both vitamin D sufficiency and depression could significantly benefit cognitive health, especially in diabetic individuals.
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Affiliation(s)
- Chang Shu
- Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Chenguang Zheng
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
| | - Xin Du
- Tianjin Huanhu Hospital, Tianjin, China
| | - Da Luo
- Tianjin Huanhu Hospital, Tianjin, China
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Liu Y, Gao X, Zhang Y, Zeng M, Liu Y, Wu Y, Hu W, Lai Y, Liao J. Geographical variation in dementia prevalence across China: a geospatial analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101117. [PMID: 38974661 PMCID: PMC11225804 DOI: 10.1016/j.lanwpc.2024.101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/25/2024] [Accepted: 05/30/2024] [Indexed: 07/09/2024]
Abstract
Background Dementia poses great health and social challenges in China. Dementia prevalence may vary across geographic areas, while comparable estimations on provincial level is lacking. This study aims to estimate dementia prevalence by provinces across China, taking into account risk factors of individual level and potential spatial correlation of provinces. Methods In this study, 17,176 adults aged 50 years or older were included from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS 2018), covering 28 provinces, autonomous regions and municipalities. To improve provincial representativeness, we constructed provincial survey weights based on China 7th census (2020). The prevalence of dementia and 95% Bayesian credible intervals (BCIs) were estimated using a Bayesian conditional autoregressive (CAR) model with spatially varying coefficients of covariates. Findings The weighted prevalence of dementia at provincial level in China in 2018 ranged from 2.62% (95%BCI: 1.70%, 3.91%) to 13.53% (95%BCI: 8.82%, 20.93%). High dementia prevalence was concentrated in North China, with a prominent high-high cluster, while provinces of low prevalence were concentrated on East and South China, characterized by a low-low cluster. Ordered by the median estimation of prevalence, the top 10% of provinces, include Xinjiang, Jilin, and Beijing. Meanwhile, Fujian, Zhejiang, and Guangdong rank among the last. The association between dementia prevalence and drinking, smoking, social isolation, physical inactivity, hearing impairment, hypertension, and diabetes exhibits provincial variation. Interpretation Our study identifies a geospatial disparity in dementia prevalence and risk factor effects across China's provinces, with high-high and low-low clusters in some northern and southern provinces, respectively. The findings emphasize the need for targeted strategies, such as addressing hypertension and hearing impairment, in specific regions for more effective dementia prevention and treatment. Funding National Science Foundation of China/the Economic and Social Research Council, UK Research and Innovation joint call: Understanding and Addressing Health and Social Challenges for Ageing in the UK and China. UK-China Health And Social Challenges Ageing Project (UKCHASCAP): present and future burden of dementia, and policy responses (grant number 72061137003, ES/T014377/1).
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Affiliation(s)
- Yixuan Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Xinyuan Gao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yongjin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Minrui Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yuyang Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Yanjuan Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Weihua Hu
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100871, China
| | - Yingsi Lai
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Jing Liao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
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Ghosh A, S M, Sunny AS, Diwakar L, Issac TG. Prevalence and patterns of vitamin D deficiency and its role in cognitive functioning in a cohort from South India. Sci Rep 2024; 14:11215. [PMID: 38755311 PMCID: PMC11099011 DOI: 10.1038/s41598-024-62010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024] Open
Abstract
Vitamin D (VitD) is a naturally occurring, fat-soluble vitamin which regulates calcium and phosphate homeostasis in the human body and is also known to have a neuroprotective role. VitD deficiency has often been associated with impaired cognition and a higher risk of dementia. In this study, we aimed to explore the relationship between levels of VitD and cognitive functioning in adult individuals. 982 cognitively healthy adults (≥ 45 years) were recruited as part of the CBR-Tata Longitudinal Study for Aging (TLSA). Addenbrooke's cognitive examination-III (ACE-III) and Hindi mental status examination (HMSE) were used to measure cognitive functioning. 25-hydroxyvitamin D [25(OH)D] levels were measured from the collected serum sample and classified into three groups- deficient (< 20 ng/ml), insufficient (20-29 ng/ml) and normal (≥ 30 ng/ml). Statistical analysis was done using IBM SPSS software, version 28.0.1.1(15). The mean age of the participants was 61.24 ± 9 years. Among 982 participants, 572 (58%) were deficient, 224 (23%) insufficient and only 186 (19%) had normal levels of VitD. Kruskal-Wallis H test revealed a significant difference in age (p = 0.015) and education (p = 0.021) across VitD levels and the Chi-square test revealed a significant association between gender (p = 0.001) and dyslipidemia status (p = 0.045) with VitD levels. After adjusting for age, education, gender and dyslipidemia status, GLM revealed that individuals with deficient (p = 0.038) levels of VitD had lower scores in ACE-III verbal fluency as compared to normal. Additionally, we also found that 91.2% individuals who had VitD deficiency were also having dyslipidemia. It is concerning that VitD deficiency impacts lipid metabolism. Lower levels of VitD also negatively impacts verbal fluency in adult individuals. Verbal fluency involves higher order cognitive functions and this result provides us with a scope to further investigate the different domains of cognition in relation to VitD deficiency and other associated disorders.
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Affiliation(s)
- Aishwarya Ghosh
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Monisha S
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Albert Stezin Sunny
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Latha Diwakar
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Thomas Gregor Issac
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India.
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Fang A, Zhao Y, Yang P, Zhang X, Giovannucci EL. Vitamin D and human health: evidence from Mendelian randomization studies. Eur J Epidemiol 2024; 39:467-490. [PMID: 38214845 DOI: 10.1007/s10654-023-01075-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 10/30/2023] [Indexed: 01/13/2024]
Abstract
We summarized the current evidence on vitamin D and major health outcomes from Mendelian randomization (MR) studies. PubMed and Embase were searched for original MR studies on vitamin D in relation to any health outcome from inception to September 1, 2022. Nonlinear MR findings were excluded due to concerns about the validity of the statistical methods used. A meta-analysis was preformed to synthesize study-specific estimates after excluding overlapping samples, where applicable. The methodological quality of the included studies was evaluated according to the STROBE-MR checklist. A total of 133 MR publications were eligible for inclusion in the analyses. The causal association between vitamin D status and 275 individual outcomes was examined. Linear MR analyses showed genetically high 25-hydroxyvitamin D (25(OH)D) concentrations were associated with reduced risk of multiple sclerosis incidence and relapse, non-infectious uveitis and scleritis, psoriasis, femur fracture, leg fracture, amyotrophic lateral sclerosis, anorexia nervosa, delirium, heart failure, ovarian cancer, non-alcoholic fatty liver disease, dyslipidemia, and bacterial pneumonia, but increased risk of Behçet's disease, Graves' disease, kidney stone disease, fracture of radium/ulna, basal cell carcinoma, and overall cataracts. Stratified analyses showed that the inverse association between genetically predisposed 25(OH)D concentrations and multiple sclerosis risk was significant and consistent regardless of the genetic instruments GIs selected. However, the associations with most of the other outcomes were only pronounced when using genetic variants not limited to those in the vitamin D pathway as GIs. The methodological quality of the included MR studies was substantially heterogeneous. Current evidence from linear MR studies strongly supports a causal role of vitamin D in the development of multiple sclerosis. Suggestive support for a number of other health conditions could help prioritize conditions where vitamin D may be beneficial or harmful.
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Affiliation(s)
- Aiping Fang
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Yue Zhao
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Ping Yang
- School of Nursing, Peking University, Beijing, China
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Xuehong Zhang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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6
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da Silva AD, Oliveira JS, de Castro IC, Paiva WC, Gomes JMG, Pimenta LCJP. Association of vitamin D and cognition in people with type 2 diabetes: a systematic review. Nutr Rev 2024; 82:622-638. [PMID: 37403328 DOI: 10.1093/nutrit/nuad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
CONTEXT There is a high prevalence of vitamin D deficiency and impaired cognitive function in people with type 2 diabetes mellitus (T2DM). OBJECTIVE To critically and systematically review the literature on the association between vitamin D status and cognitive performance in people with type 2 diabetes. DATA SOURCES This review was conducted according to PRISMA recommendations. MEDLINE, SCOPUS, the Cochrane Library, and Web of Science databases were searched using the terms "Diabetes Mellitus, Type 2", "Cognitive Function", and "Vitamin D". DATA EXTRACTION Eight observational and 1 randomized study were included, containing data of 14 648 adult and elderly individuals (19-74 y). All extracted data were compiled, compared, and critically analyzed. DATA ANALYSIS There is no strong evidence that lower serum concentrations of vitamin D and vitamin D-binding protein are associated with worsening cognitive function in individuals with T2DM. Vitamin D supplementation (12 wk) improved the scores of some executive functioning tests, although there was no difference between low doses (5000 IU/wk) and high doses (50 000 IU/wk). CONCLUSIONS There is no high-quality evidence demonstrating an association between vitamin D status and cognitive function, or clinical benefits on cognition from vitamin D supplementation in individuals with T2DM. Future studies are needed. Systematic Review Registration: PROSPERO registration no. CRD42021261520.
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Affiliation(s)
- Alice D da Silva
- Department of Nutrition, Universidade Federal de Lavras, Minas Gerais, Brazil
| | - Julia S Oliveira
- Department of Nutrition and Health, Universidade Federal de Viçosa, Minas Gerais, Brazil
| | - Isabela C de Castro
- Department of Nutrition, Universidade Federal de Lavras, Minas Gerais, Brazil
| | - Wanderléia C Paiva
- Instituto Federal de Educação, Ciência e Tecnologia do Sudeste de Minas Gerais, Minas Gerais, Brazil
| | - Júnia M G Gomes
- Instituto Federal de Educação, Ciência e Tecnologia do Sudeste de Minas Gerais, Minas Gerais, Brazil
| | - Laura C J P Pimenta
- Department of Nutrition, Universidade Federal de Lavras, Minas Gerais, Brazil
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Chen LJ, Sha S, Stocker H, Brenner H, Schöttker B. The associations of serum vitamin D status and vitamin D supplements use with all-cause dementia, Alzheimer's disease, and vascular dementia: a UK Biobank based prospective cohort study. Am J Clin Nutr 2024; 119:1052-1064. [PMID: 38296029 PMCID: PMC11007746 DOI: 10.1016/j.ajcnut.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Prior studies on vitamin D and dementia outcomes yielded mixed results and had several important limitations. OBJECTIVES We aimed to assess the associations of both serum vitamin D status and supplementation with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD) incidence. METHODS With a prospective cohort study design, we comprehensively assessed the associations of vitamin D and multivitamin supplementation, as well as vitamin D deficiency {25-hydroxyvitamin D [25(OH)D] <30 nmol/L}, and insufficiency [25(OH)D 30 to <50 nmol/L], with the 14-year incidence of all-cause dementia, AD, and VD in 269,229 participants, aged 55 to 69, from the UK Biobank. RESULTS Although 5.0% reported regular vitamin D use and 19.8% reported multivitamin use, the majority of participants exhibited either vitamin D deficiency (18.3%) or insufficiency (34.0%). However, vitamin D deficiency was less prevalent among users of vitamin D (6.9%) or multivitamin preparations (9.5%) than among nonusers (21.5%). Adjusted Cox regression models demonstrated 19% to 25% increased risk of all 3 dementia outcomes for those with vitamin D deficiency [hazard ratio (HR) 95% confidence interval (CI)]: 1.25 (1.16, 1.34) for all-cause dementia; 1.19 (1.07-1.31) for AD; 1.24 (1.08-1.43) for VD] and 10% to 15% increased risk of those with vitamin D insufficiency [HR (95% CI): 1.11 (1.05, 1.18) for all-cause dementia; 1.10 (1.02-1.19) for AD; 1.15 (1.03-1.29) for VD]. Regular users of vitamin D and multivitamins had 17% and 14% lower risk of AD [HR (95% CI): 0.83 (0.71, 0.98)] and VD [HR (95% CI): 0.86 (0.75, 0.98)] incidence, respectively. CONCLUSIONS Although our findings indicate the potential benefits of vitamin D supplementation for dementia prevention, randomized controlled trials are essential for definitive evidence.
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Affiliation(s)
- Li-Ju Chen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Sha Sha
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Hannah Stocker
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany; Network Aging Research, Heidelberg University, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany; Network Aging Research, Heidelberg University, Heidelberg, Germany.
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Jain SK, Stevens CM, Margret JJ, Levine SN. Alzheimer's Disease: A Review of Pathology, Current Treatments, and the Potential Therapeutic Effect of Decreasing Oxidative Stress by Combined Vitamin D and l-Cysteine Supplementation. Antioxid Redox Signal 2024; 40:663-678. [PMID: 37756366 PMCID: PMC11001507 DOI: 10.1089/ars.2023.0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023]
Abstract
Significance: Excess oxidative stress and neuroinflammation are risk factors in the onset and progression of Alzheimer's disease (AD) and its association with amyloid-β plaque accumulation. Oxidative stress impairs acetylcholine (ACH) and N-methyl-d-aspartate receptor signaling in brain areas that function in memory and learning. Glutathione (GSH) antioxidant depletion positively correlates with the cognitive decline in AD subjects. Treatments that upregulate GSH and ACH levels, which simultaneously decrease oxidative stress and inflammation, may be beneficial for AD. Recent Advances: Some clinical trials have shown a benefit of monotherapy with vitamin D (VD), whose deficiency is linked to AD or with l-cysteine (LC), a precursor of GSH biosynthesis, in reducing mild cognitive impairment. Animal studies have shown a simultaneous decrease in ACH esterase (AChE) and increase in GSH; combined supplementation with VD and LC results in a greater decrease in oxidative stress and inflammation, and increase in GSH levels compared with monotherapy with VD or LC. Therefore, cosupplementation with VD and LC has the potential of increasing GSH, downregulation of oxidative stress, and decreased inflammation and AChE levels. Future Directions: Clinical trials are needed to determine whether safe low-cost dietary supplements, using combined VD+LC, have the potential to alleviate elevated AChE, oxidative stress, and inflammation levels, thereby halting the onset of AD. Goal of Review: The goal of this review is to highlight the pathological hallmarks and current Food and Drug Administration-approved treatments for AD, and discuss the potential therapeutic effect that cosupplementation with VD+LC could manifest by increasing GSH levels in patients. Antioxid. Redox Signal. 40, 663-678.
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Affiliation(s)
- Sushil K. Jain
- Department of Pediatrics and Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
| | - Christopher M. Stevens
- Department of Pediatrics and Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
| | - Jeffrey Justin Margret
- Department of Pediatrics and Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
| | - Steven N. Levine
- Department of Pediatrics and Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
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Vyas CM, Kang JH, Mischoulon D, Cook NR, Reynolds III CF, Chang G, Mora S, De Vivo I, Manson JE, Okereke OI. Apolipoprotein E and Its Association With Cognitive Change and Modification of Treatment Effects of Vitamin D3 and Omega-3s on Cognitive Change: Results From the In-Clinic Subset of a Randomized Clinical Trial. J Gerontol A Biol Sci Med Sci 2024; 79:glad260. [PMID: 37952113 PMCID: PMC10876077 DOI: 10.1093/gerona/glad260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Apolipoprotein E (APOE)-ε4 allele is associated with cognitive decline; however, its potential to modify effects of vitamin D3 and omega-3s supplementation on later-life cognition is unclear. Our objectives were to estimate among the in-clinic subset of a randomized trial: (1) associations between APOE-ε4 and global and domain-specific cognitive change, with exploration of potential sex and race differences; and (2) modification by APOE-ε4 of effects of vitamin D3 and omega-3s supplementation on cognitive change. METHODS From an ancillary study of depression prevention within a completed 2 × 2 factorial trial testing vitamin D3 (2 000 IU per day), omega-3s (1 g per day), and/or placebos, we included 743 older adults with baseline in-person neuropsychiatric assessments and APOE genotyping data. The primary outcome was change in global cognition (averaging z-scores of 9 tests) over 2 years. Secondarily, episodic memory and executive function/attention z-scores were examined. General linear models of response profiles with multiplicative interaction terms were constructed; stratified results were reported. RESULTS Mean age (standard deviation) was 67.1 (5.3) years; 50.6% were females; 24.9% were APOE-ε4 carriers. Compared to noncarriers, APOE-ε4 carriers had worse 2-year change in global cognition and episodic memory; differences were more apparent among females than males. There was no variation by race in APOE-ε4 associations with cognition. APOE-ε4 did not significantly modify effects of vitamin D3 or omega-3s, compared to placebo, on change in global cognition, episodic memory, or executive function/attention. CONCLUSIONS APOE-ε4 was associated with worse cognition but did not modify overall effects of vitamin D3 or omega-3 supplementation on cognition over 2 years.
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Affiliation(s)
- Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy R Cook
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Charles F Reynolds III
- Department of Psychiatry, UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Grace Chang
- Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts, USA
| | - Samia Mora
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Immaculata De Vivo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Sirakawin C, Lin D, Zhou Z, Wang X, Kelleher R, Huang S, Long W, Pires‐daSilva A, Liu Y, Wang J, Vinnikov IA. SKN-1/NRF2 upregulation by vitamin A is conserved from nematodes to mammals and is critical for lifespan extension in Caenorhabditis elegans. Aging Cell 2024; 23:e14064. [PMID: 38100161 PMCID: PMC10928581 DOI: 10.1111/acel.14064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 03/13/2024] Open
Abstract
Vitamin A (VA) is a micronutrient essential for the physiology of many organisms, but its role in longevity and age-related diseases remains unclear. In this work, we used Caenorhabditis elegans to study the impact of various bioactive compounds on lifespan. We demonstrate that VA extends lifespan and reduces lipofuscin and fat accumulation while increasing resistance to heat and oxidative stress. This resistance can be attributed to high levels of detoxifying enzymes called glutathione S-transferases, induced by the transcription factor skinhead-1 (SKN-1). Notably, VA upregulated the transcript levels of skn-1 or its mammalian ortholog NRF2 in both C. elegans, human cells, and liver tissues of mice. Moreover, the loss-of-function genetic models demonstrated a critical involvement of the SKN-1 pathway in longevity extension by VA. Our study thus provides novel insights into the molecular mechanism of anti-aging and anti-oxidative effects of VA, suggesting that this micronutrient could be used for the prevention and/or treatment of age-related disorders.
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Affiliation(s)
- Chaweewan Sirakawin
- Laboratory of Molecular Neurobiology, Sheng Yushou Center of Cell Biology and Immunology, Department of Genetics and Developmental Biology, School of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Dongfa Lin
- Laboratory of Molecular Neurobiology, Sheng Yushou Center of Cell Biology and Immunology, Department of Genetics and Developmental Biology, School of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
- Key Laboratory for Molecular Enzymology and Engineering, School of Life SciencesJilin UniversityChangchunChina
| | - Ziyue Zhou
- Laboratory of Molecular Neurobiology, Sheng Yushou Center of Cell Biology and Immunology, Department of Genetics and Developmental Biology, School of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Xiaoxin Wang
- Shanghai Key Laboratory of Pancreatic Diseases, Institute of Translational Medicine, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | | | - Shangyuan Huang
- Laboratory of Molecular Neurobiology, Sheng Yushou Center of Cell Biology and Immunology, Department of Genetics and Developmental Biology, School of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Weimiao Long
- Laboratory of Molecular Neurobiology, Sheng Yushou Center of Cell Biology and Immunology, Department of Genetics and Developmental Biology, School of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | | | - Yu Liu
- Laboratory of Molecular Neurobiology, Sheng Yushou Center of Cell Biology and Immunology, Department of Genetics and Developmental Biology, School of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Jingjing Wang
- Shanghai Key Laboratory of Pancreatic Diseases, Institute of Translational Medicine, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Ilya A. Vinnikov
- Laboratory of Molecular Neurobiology, Sheng Yushou Center of Cell Biology and Immunology, Department of Genetics and Developmental Biology, School of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
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11
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Shea MK, Xuan AY, Booth SL. Vitamin D, Alzheimer's disease and related dementia. ADVANCES IN FOOD AND NUTRITION RESEARCH 2024; 109:185-219. [PMID: 38777413 DOI: 10.1016/bs.afnr.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Vitamin D has been proposed as a potential strategy to mitigate age-related cognitive decline and dementia, including Alzheimer's dementia, the predominant type of dementia. Rodent studies have provided insight into the potential mechanisms underlying the role of vitamin D in Alzheimer's disease and dementia. However, inconsistencies with respect to age, sex, and genetic background of the rodent models used poses some limitations regarding scientific rigor and translation. Several human observational studies have evaluated the association of vitamin D status with cognitive decline and dementia, and the results are conflicting. Randomized clinical trials of vitamin D supplementation have included cognitive outcomes. However, most of the available trials have not been designed specifically to test the effect of vitamin D on age-related cognitive decline and dementia, so it remains questionable how much additional vitamin D will improve cognitive performance. Here we evaluate the strengths and limitations of the available evidence regarding the role of vitamin D in AD, cognitive decline, dementia.
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Affiliation(s)
- M Kyla Shea
- Tufts University USDA Human Nutrition Research Center on Aging.
| | - Andrew Y Xuan
- Tufts University USDA Human Nutrition Research Center on Aging
| | - Sarah L Booth
- Tufts University USDA Human Nutrition Research Center on Aging
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12
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Ilboudo Y, Yoshiji S, Lu T, Butler-Laporte G, Zhou S, Richards JB. Vitamin D, Cognition, and Alzheimer's Disease: Observational and Two-Sample Mendelian Randomization Studies. J Alzheimers Dis 2024; 99:1243-1260. [PMID: 38820015 DOI: 10.3233/jad-221223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Background Observational studies have found that vitamin D supplementation is associated with improved cognition. Further, recent Mendelian randomization (MR) studies have shown that higher vitamin D levels, 25(OH)D, may protect against Alzheimer's disease. Thus, it is possible that 25(OH)D may protect against Alzheimer's disease by improving cognition. Objective We assessed this hypothesis, by examining the relationship between 25(OH)D levels and seven cognitive measurements. Methods To mitigate bias from confounding, we performed two-sample MR analyses. We used instruments from three publications: Manousaki et al. (2020), Sutherland et al. (2022), and the Emerging Risk Factors Collaboration/EPIC-CVD/Vitamin D Studies Collaboration (2021). Results Our observational studies suggested a protective association between 25(OH)D levels and cognitive measures. An increase in the natural log of 25(OH)D by 1 SD was associated with a higher PACC score (BetaPACC score = 0.06, 95% CI = (0.04-0.08); p = 1.8×10-10). However, in the MR analyses, the estimated effect of 25(OH)D on cognitive measures was null. Specifically, per 1 SD increase in genetically estimated natural log of 25(OH)D, the PACC scores remained unchanged in the overall population, (BetaPACC score = -0.01, 95% CI (-0.06 to 0.03); p = 0.53), and amongst individuals aged over 60 (BetaPACC score = 0.03, 95% CI (-0.028 to 0.08); p = 0.35). Conclusions In conclusion, our MR study found no clear evidence to support a protective role of increased 25(OH)D concentrations on cognitive performance in European ancestry individuals. However, our study cannot entirely dismiss the potential beneficial effect on PACC for individuals over the age of 60.
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Affiliation(s)
- Yann Ilboudo
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Satoshi Yoshiji
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- Kyoto-McGill International Collaborative Program in Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tianyuan Lu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Statistical Sciences, University of Toronto, Toronto, ON, Canada
- Department of Twin Research, King's College London, London, UK
| | | | - Sirui Zhou
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - J Brent Richards
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
- Department of Twin Research, King's College London, London, UK
- 5 Prime Sciences, Montréal, QC, Canada
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13
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Zeqaj I, Piffero R, Calzaducca E, Pirisi M, Bellan M. The Potential Role of Vitamin D Supplementation in Cognitive Impairment Prevention. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:628-637. [PMID: 36998124 DOI: 10.2174/1871527322666230328130417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Vitamin D is implicated in many processes in the central nervous system (CNS), such as neurogenesis, neurotransmitter synthesis, synaptogenesis and protection against oxidative stress, thereby exerting a neuroprotective effect. OBJECTIVE In the present review, we aimed to evaluate the potential benefit(s) of vitamin D supplementation for CNS aging in different clinical contexts. METHODS We performed a literature search, looking for clinical trials and randomized clinical trials evaluating the effect of vitamin D supplementation on different endpoints related to cognitive outcomes. RESULTS Firstly, we identified 16 papers dealing with the impact of vitamin D supplementation on cognitive function in healthy subjects; the current literature suggests a real role for vitamin D supplementation in the prevention of cognitive decay in this clinical setting. Conversely, two papers suggest that vitamin D supplementation may be beneficial in patients with mild cognitive impairment (MCI). Finally, current data on vitamin D in Alzheimer's disease are contradictory. CONCLUSION Vitamin D supplementation may improve the cognitive outcomes of patients with MCI, whereas there is no evidence that it may prevent dementia or modulate the course of Alzheimer's disease.
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Affiliation(s)
- Iris Zeqaj
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Roberto Piffero
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Elisa Calzaducca
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Mario Pirisi
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
- CAAD, (Center for Translational Research on Autoimmune and Allergic Disease) Università del Piemonte Orientale UPO, Novara, Italy
| | - Mattia Bellan
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
- CAAD, (Center for Translational Research on Autoimmune and Allergic Disease) Università del Piemonte Orientale UPO, Novara, Italy
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14
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Vyas CM, Manson JE, Sesso HD, Rist PM, Weinberg A, Kim E, Moorthy MV, Cook NR, Okereke OI. Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial. Am J Clin Nutr 2024; 119:39-48. [PMID: 38070683 PMCID: PMC11347806 DOI: 10.1016/j.ajcnut.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/21/2023] [Accepted: 10/31/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Some prior randomized clinical trials (RCTs) that tested the effects of cocoa extract (CE), a source of flavanols, on late-life cognition have yielded promising findings. A long-term RCT using in-person neuropsychological tests covering multiple cognitive domains may clarify the cognitive effects of CE. OBJECTIVES To test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y. METHODS The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a 2 × 2 factorial RCT of CE [500 mg flavanols/d, including 80 mg (-)-epicatechin] and/or a daily multivitamin-mineral supplement for cardiovascular disease and cancer prevention among 21,442 United States adults aged ≥60 y. There were 573 participants in the clinic subcohort of COSMOS (that is, COSMOS-Clinic) who completed all cognitive tests at baseline; of these, 492 completed 2-y follow-up assessments. The primary outcome was global cognition (averaging z-scores across 11 tests). Secondary outcomes were episodic memory and executive function/attention. Repeated measures models were used to compare randomized groups. RESULTS Participants' mean age (standard deviation) was 69.6 (5.3); 49.2% were females. Daily supplementation with CE, compared with placebo, had no significant effect on 2-y change in global cognition {mean difference [95% confidence interval (CI)]: -0.01 (-0.08, 0.05) standard deviation units (SU)}. CE, compared with placebo, had no significant effects on 2-y change in episodic memory [mean difference (95% CI): -0.01 (-0.13, 0.10) SU] or executive function/attention [mean difference (95% CI): 0.003 (-0.07, 0.08) SU]. Subgroup analyses uncorrected for multiple-testing suggested cognitive benefits of CE supplementation, compared with placebo among those with poorer baseline diet quality. CONCLUSIONS Among 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study. TRIAL REGISTRATION This trial was registered at clinicaltrials.gov with identifier - NCT02422745.
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Affiliation(s)
- Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Alison Weinberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Eunjung Kim
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - M Vinayaga Moorthy
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Nancy R Cook
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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15
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Lai YC, Chen YH, Liang FW, Wu YC, Wang JJ, Lim SW, Ho CH. Determinants of cancer incidence and mortality among people with vitamin D deficiency: an epidemiology study using a real-world population database. Front Nutr 2023; 10:1294066. [PMID: 38130443 PMCID: PMC10733456 DOI: 10.3389/fnut.2023.1294066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction This study aimed to investigate the determinants of cancer incidence and mortality in patients with vitamin D deficiency using a real-world population database. Methods We utilized the International Diagnostic Classification Code (ICD9:268 / ICD10: E55) to define patients with vitamin D deficiency. Additionally, the Cox regression model was used to estimate overall mortality and identify potential factors contributing to mortality in cancer patients. Results In 5242 patients with vitamin D deficiency, the development of new-onset cancer was 229 (4.37%) patients. Colon cancer was the most prevalent cancer type. After considering confounding factors, patients aged 50-65 and more than 65 indicated a 3.10-fold (95% C.I.: 2.12-4.51) and 4.55-fold (95% C.I.: 3.03-6.82) cancer incidence, respectively compared with those aged <50. Moreover, patients with comorbidities of diabetes mellitus (DM) (HR: 1.56; 95% C.I.: 1.01-2.41) and liver disease (HR: 1.62; 95% C.I.: 1.03-2.54) presented a higher cancer incidence rate than those without DM/ liver disease. In addition, vitamin D deficiency patients with cancer and dementia histories indicated a significantly higher mortality risk (HR: 4.04; 95% C.I.: 1.05- 15.56) than those without dementia. Conclusion In conclusion, our study revealed that vitamin D deficiency patients with liver disease had an increased incidence of cancer, while those with dementia had an increased mortality rate among cancer patients.
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Affiliation(s)
- Yi-Chen Lai
- Department of Emergency Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Han Chen
- Department of Family Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Fu-Wen Liang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Cih Wu
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Sher-Wei Lim
- Department of Neurosurgery, Chi Mei Medical Center, Chiali, Tainan, Taiwan
- Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
- Cancer Center, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
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16
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Ciobanu AM, Petrescu C, Anghele C, Manea MC, Ciobanu CA, Petrescu DM, Antonia MO, Riga S. Severe Vitamin D Deficiency-A Possible Cause of Resistance to Treatment in Psychiatric Pathology. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2056. [PMID: 38138159 PMCID: PMC10744484 DOI: 10.3390/medicina59122056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023]
Abstract
In the last few years, vitamin D functions have been studied progressively, and along with their main role in regulating calcium homeostasis, the potential function in the nervous system and the link between different psychiatric disorders and vitamin D deficiency have been revealed. The discovery of vitamin D receptors in multiple brain structures, like the hippocampus, led to the hypothesis that vitamin D deficiency could be responsible for treatment resistance in psychiatric diseases. The aim of this study was to analyze the current knowledge in the literature regarding vitamin D deficiency among individuals afflicted with psychiatric disorders and assess the potential therapeutic benefits of vitamin D supplementation. A systematic search was conducted on the PubMed database for articles published in the last five years (2016-2022) in English, focusing on human subjects. Results show that vitamin D deficiency has implications for numerous psychiatric disorders, affecting mood and behavior through its influence on neurotransmitter release, neurotrophic factors, and neuroprotection. It also plays a role in modulating inflammation, which is often elevated in psychiatric disorders. In conclusion, vitamin D deficiency is prevalent and has far-reaching implications for mental health. This review underscores the importance of exploring the therapeutic potential of vitamin D supplementation in individuals with psychiatric disorders and highlights the need for further research in this complex field.
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Affiliation(s)
- Adela Magdalena Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Cristian Petrescu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Cristina Anghele
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Mihnea Costin Manea
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | | | - Diana Mihaela Petrescu
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Mihalache Oana Antonia
- Neurology Clinic, “Fundeni” Clinical Institute, 022328 Bucharest, Romania
- Department of Stress Research and Prophylaxis, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
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Turkmen BO, Can B, Buker S, Beser B, Büyükgök D, Dernek B, Bovatekin S, Kucukdagli P, Ilhan B, Kalem ŞA, Erten N, Karan MA, Bahat G. The effect of vitamin D on neurocognitive functions in older vitamin D deficient adults: a pilot longitudinal interventional study. Psychogeriatrics 2023; 23:781-788. [PMID: 37391231 DOI: 10.1111/psyg.12997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND The relationship between vitamin D and cognitive status remains controversial. We aimed to evaluate the effect of vitamin D replacement on cognitive functions in healthy and cognitively intact vitamin D deficient older females. METHODS This study was designed as a prospective interventional study. A total of 30 female adults aged ≥60 with a serum 25 (OH) vitamin D level of <10 ng/ml were included. Participants were administered 50 000 IU vitamin D3 weekly for 8 weeks followed by a maintenance therapy of 1000 U/day. Detailed neuropsychological assessment was performed prior to vitamin D replacement and repeated at 6 months by the same psychologist. RESULTS Mean age was 63 ± 6.7 years and baseline vitamin D level was 7.8 ± 2.0 (range: 3.5-10.3) ng/ml. At 6 months, vitamin D level was 32.5 ± 3.4 (32.2-55) ng/ml. The Judgement of Line Orientation Test (P = 0.04), inaccurate word memorizing of the Verbal Memory Processes Test (P = 0.02), perseveration scores of the Verbal Memory Processes Test (P = 0.005), topographical accuracy of the Warrington Recognition Memory Test (P = 0.002), and the spontaneous self-correction of an error in the Boston Naming Test (P = 0.003) scores increased significantly, while the delayed recall score in the Verbal Memory Processes Test (P = 0.03), incorrect naming of words in the Boston Naming Test (P = 0.04), interference time of the Stroop Test (P = 0.05), and spontaneous corrections of the Stroop Test (P = 0.02) scores decreased significantly from baseline. CONCLUSION Vitamin D replacement has a positive effect on cognitive domains related to visuospatial, executive, and memory processing functions.
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Affiliation(s)
- Banu Ozulu Turkmen
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Busra Can
- Department of Internal Medicine, Division of Geriatrics, Marmara University Medical School, Istanbul, Turkey
| | - Seda Buker
- Department of Neuroscience, Istanbul University, Istanbul, Turkey
| | - Birsu Beser
- Department of Neuroscience, Istanbul University, Istanbul, Turkey
| | - Deniz Büyükgök
- Department of Neuroscience, Istanbul University, Istanbul, Turkey
| | - Bahar Dernek
- Physical Medicine and Rehabilitation Clinic, Istanbul Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Sevilay Bovatekin
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Pınar Kucukdagli
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Birkan Ilhan
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | | | - Nilgun Erten
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Mehmet Akif Karan
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Gulistan Bahat
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
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18
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Barmaki O, Mansour A, Moodi M, Mirahmad M, Fakhrzadeh H, Arzaghi M, Khorashadi M, Khodabakhshi H, Esmaeili AA, Sharifzadeh G, Zarban A, Sharifi F, Sajjadi-Jazi SM. Serum Vitamin D Status and Cognitive Function in Iranian Older Adults: Evidence from the Birjand Longitudinal Aging Study. J Nutr 2023; 153:2312-2319. [PMID: 37356498 DOI: 10.1016/j.tjnut.2023.06.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/14/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND There is evidence of the role of vitamin D deficiency in cognitive decline. However, the results of studies regarding the relationship between the reduction of vitamin D concentrations and cognitive impairment are heterogeneous. OBJECTIVES We aimed to answer the question of whether vitamin D deficiency is associated with cognitive decline in older adults. METHODS In this cross-sectional study, the baseline data of the Birjand Longitudinal Aging Study (BLAS) were analyzed. Of 1420 participants in the BLAS, 1219 participants aged ≥60 y old were included in the present study. Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by the enzyme-linked immunosorbent assay method. The 6-item Cognitive Impairment Test (6-CIT), Mini-Mental State Examination (MMSE), Category Fluency Test (CFT), and Abbreviated Mental Test Score (AMTS) were used to assess cognitive function. Multiple logistic regression analysis, adjusted for potential confounders, was employed to estimate the association between cognitive function and 25(OH)D concentrations. RESULTS Among study participants, 905 (74.24%) had sufficient vitamin D concentrations (≥20 ng/ml), 209 (17.15%) had insufficient vitamin D concentrations (12-20 ng/ml), and 105 (8.61%) had vitamin D deficiency (<12 ng/ml). There was no significant correlation between serum 25(OH)D concentrations and scores of 6-CIT (P = 0.279), AMTS (P = 0.181), MMSE (P = 0.118), and CFT (P = 0.259). Also, the prevalence of cognitive impairment had no significant relationship with vitamin D status. Finally, in the multiple logistic regression analysis, there was no association between the insufficient or deficient concentrations of 25(OH)D and impaired cognitive function both before and after adjustment for various cofounders. CONCLUSIONS The present study found no significant association between vitamin D status and cognitive impairment.
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Affiliation(s)
- Ozra Barmaki
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Asieh Mansour
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Maryam Mirahmad
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Khorashadi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Huriye Khodabakhshi
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Iranian Research Center of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Akbar Esmaeili
- Department of Psychiatry, School of Medicine Medical Toxicology & Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Gholamreza Sharifzadeh
- Department of Epidemiology and Biostatistics, School of Health, Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Asghar Zarban
- Department of Clinical Biochemistry, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sayed Mahmoud Sajjadi-Jazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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19
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Ye X, Zhou Q, Ren P, Xiang W, Xiao L. The Synaptic and Circuit Functions of Vitamin D in Neurodevelopment Disorders. Neuropsychiatr Dis Treat 2023; 19:1515-1530. [PMID: 37424961 PMCID: PMC10327924 DOI: 10.2147/ndt.s407731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Vitamin D deficiency/insufficiency is a public health issue around the world. According to epidemiological studies, low vitamin D levels have been associated with an increased risk of some neurodevelopmental disorders, including autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Animal models reveal that vitamin D has a variety of impacts on the synapses and circuits in the brain. A lack of vitamin D affects the expression of synaptic proteins, as well as the synthesis and metabolism of various neurotransmitters. Depending on where vitamin D receptors (VDRs) are expressed, vitamin D may also regulate certain neuronal circuits through the endocannabinoid signaling, mTOR pathway and oxytocin signaling. While inconsistently, some data suggest that vitamin D supplementation may be able to reduce the core symptoms of ASD and ADHD. This review emphasizes vitamin D's role in the synaptic and circuit mechanisms of neurodevelopmental disorders including ASD and ADHD. Future application of vitamin D in these disorders will depend on both basic research and clinical studies, in order to make the transition from the bench to the bedside.
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Affiliation(s)
- Xiaoshan Ye
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
| | - Qionglin Zhou
- International School of Public Health and One Health, Hainan Medical University, Haikou, People’s Republic of China
| | - Pengcheng Ren
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
- National Health Commission (NHC) Key Laboratory of Control of Tropical Diseases, Hainan Medical University, Haikou, People’s Republic of China
- School of Basic Medicine and Life Science, Hainan Medical University, Haikou, People’s Republic of China
| | - Wei Xiang
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
- National Health Commission (NHC) Key Laboratory of Control of Tropical Diseases, Hainan Medical University, Haikou, People’s Republic of China
| | - Le Xiao
- Hainan Women and Children’s Medical Center, School of Pediatrics, Hainan Medical University, Haikou, People’s Republic of China
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20
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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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21
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Harse JD, Marriott RJ, Zhu K, Murray K, Bucks RS. Vitamin D status and cognitive performance in community-dwelling adults: A dose-response meta-analysis of observational studies. Front Neuroendocrinol 2023:101080. [PMID: 37268277 DOI: 10.1016/j.yfrne.2023.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/27/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023]
Abstract
Low vitamin D status is linked with poorer cognition in adults while findings in relation to high levels are mixed.We performed a systematic review and meta-analyses to examine dose-response associations between 25-hydroxyvitamin D (25OHD) levelsand cognitive performance in community-dwelling adults. Thirty-eight observational studies were included in dose-response meta-analyses. Positive, nonlinear associations were identified between baseline25OHD levels and global cognition incross-sectional and longitudinal analyses, and for performance in memory and executive function in longitudinal analyses. When restricted to studies involving older adults, thepattern emerged forspecific domains in cross-sectional analyses. Poorer performance was associated with low 25OHD levels, while a sharp improvement was associated withlevels up to 60-70 nM/L. Further improvement was observed only for longitudinal global cognition. Our findings support the association between low vitamin D and poorer cognition and suggest levels of at least 60 nM/L are associated with better cognition during ageing.
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Affiliation(s)
- Janis D Harse
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia.
| | - Ross J Marriott
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia; Medical School, University of Western Australia, Crawley, Western Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Crawley, Western Australia
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22
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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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23
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Anagnostis P, Livadas S, Goulis DG, Bretz S, Ceausu I, Durmusoglu F, Erkkola R, Fistonic I, Gambacciani M, Geukes M, Hamoda H, Hartley C, Hirschberg AL, Meczekalski B, Mendoza N, Mueck A, Smetnik A, Stute P, van Trotsenburg M, Rees M, Lambrinoudaki I. EMAS position statement: Vitamin D and menopausal health. Maturitas 2023; 169:2-9. [PMID: 36566517 DOI: 10.1016/j.maturitas.2022.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION There is increasing evidence that vitamin D has widespread tissue effects. In addition to osteoporosis, vitamin D deficiency has been associated with cardiovascular disease, diabetes, cancer, infections and neurodegenerative disease. However, the effect of vitamin D supplementation on non-skeletal outcomes requires clarification, especially in postmenopausal women. AIM This position statement provides an evidence-based overview of the role of vitamin D in the health of postmenopausal women based on observational and interventional studies. MATERIALS AND METHODS Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS Vitamin D status is determined by measuring serum 25-hydroxyvitamin D levels. Concentrations <20 ng/ml (<50 nmol/l) and <10 ng/ml (<25 nmol/l) are considered to constitute vitamin D deficiency and severe deficiency, respectively. Observational data suggest an association between vitamin D deficiency and adverse health outcomes in postmenopausal women, although they cannot establish causality. The evidence from randomized controlled trials concerning vitamin D supplementation is not robust, since many studies did not consider whether people were deficient at baseline. Moreover, high heterogeneity exists in terms of the population studied, vitamin D dosage, calcium co-administration and duration of intervention. Concerning skeletal health, vitamin D deficiency is associated with low bone mass and an increased risk of fractures. Vitamin D supplementation at maintenance doses of 800-2000 IU/day (20-50 μg/day), after repletion of vitamin D status with higher weekly or daily doses, may be of benefit only when co-administered with calcium (1000-1200 mg/day), especially in the elderly populations and those with severe vitamin D deficiency. Concerning cardiovascular disease, vitamin D deficiency is associated with an increased prevalence of cardiovascular risk factors, mainly metabolic syndrome, type 2 diabetes mellitus and dyslipidemia. Vitamin D deficiency, especially its severe form, is associated with an increased risk of cardiovascular events (coronary heart disease, stroke, mortality), independently of traditional risk factors. Vitamin D supplementation may have a modestly beneficial effect on lipid profile and glucose homeostasis, especially in obese individuals or those ≥60 years old and at doses of ≥2000 IU/day (≥50 μg/day). However, it has no effect on the incidence of cardiovascular events. Concerning cancer, vitamin D deficiency is associated with increased incidence of and mortality from several types of cancer, such as colorectal, lung and breast cancer. However, the data on other types of gynecological cancer are inconsistent. Vitamin D supplementation has no effect on cancer incidence, although a modest reduction in cancer-related mortality has been observed. Concerning infections, vitamin D deficiency has been associated with acute respiratory tract infections, including coronavirus disease 2019 (COVID-19). Vitamin D supplementation may decrease the risk of acute respiratory tract infections and the severity of COVID-19 (not the risk of infection). Concerning menopausal symptomatology, vitamin D deficiency may have a negative impact on some aspects, such as sleep disturbances, depression, sexual function and joint pains. However, vitamin D supplementation has no effect on these, except for vulvovaginal atrophy, at relatively high doses, i.e., 40,000-60,000 IU/week (1000-1500 IU/week) orally or 1000 IU/day (25 μg/day) as a vaginal suppository.
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Affiliation(s)
- Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.
| | | | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | | | - Iuliana Ceausu
- Department of Obstetrics and Gynecology I, "Carol Davila" University of Medicine and Pharmacy, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania
| | - Fatih Durmusoglu
- Istanbul Medipol International School of Medicine, Istanbul, Turkey
| | - Risto Erkkola
- Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland
| | | | - Marco Gambacciani
- Menopause and Osteoporosis Unit, San Rossore Clinical Center, Pisa, Italy
| | - Marije Geukes
- Department of Obstetrics and Gynecology, Ziekenhuisgroep Twente (Hospital Group Twente), Post box 7600, 7600 SZ Almelo, the Netherlands
| | - Haitham Hamoda
- Department Gynaecology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Caoimhe Hartley
- Menopause Health Clinic and The Rotunda Hospital, Dublin, Ireland
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Nicolas Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Spain
| | - Alfred Mueck
- Department of Women's Health, University Hospital Tuebingen, Germany; Beijing OB/GYN Hospital, Capital Medical University, China
| | - Antonina Smetnik
- Department of Gynecological Endocrinology, National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Petra Stute
- Department of Obstetrics and Gynecology, University Clinic Inselspital, Bern, Switzerland
| | - Mick van Trotsenburg
- Sigmund Freud University, Vienna, Austria and Consultancy genderPRO, Vienna, Austria
| | - Margaret Rees
- Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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24
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Study of Diet Habits and Cognitive Function in the Chinese Middle-Aged and Elderly Population: The Association between Folic Acid, B Vitamins, Vitamin D, Coenzyme Q10 Supplementation and Cognitive Ability. Nutrients 2023; 15:nu15051243. [PMID: 36904242 PMCID: PMC10005055 DOI: 10.3390/nu15051243] [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: 01/28/2023] [Revised: 02/19/2023] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
A growing body of evidence suggests that vitamin supplements play a role in the prevention of cognitive decline. The objective of the present cross-sectional study was to evaluate the relationship between cognitive ability and folic acid, B vitamins, vitamin D (VD) and Coenzyme Q10 (CoQ10) supplementation. The sample consisted of 892 adults aged above 50 who were assessed for their cognitive status in the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (China) from July 2019 to January 2022. According to the degree of cognitive impairment, the subjects were divided into a normal control (NC) group, subjective cognitive decline (SCD) group, mild cognitive impairment (MCI) group and Alzheimer's disease (AD) group. The results indicated a lower risk of AD in the daily VD-supplemented subjects with MCI compared to those who were not supplemented; a lower risk of cognitive impairment in those with normal cognitive who consumed VD, folic acid or CoQ10 on a daily basis compared those who did not; and a lower risk of cognitive impairment in subjects with normal cognitive performance who consumed B vitamin supplements, either daily or occasionally, compared to those who did not. The correlation was independent of other factors that potentially affect cognition, such as education level, age, etc. In conclusion, our findings confirmed a lower prevalence of cognitive impairment in those who took vitamins (folic acid, B vitamins, VD, CoQ10) daily. Therefore, we would recommend daily supplementation of vitamins (folic acid, B vitamins, VD, CoQ10), especially group B vitamins, as a potential preventive measure to slow cognitive decline and neurodegeneration in the elderly. However, for the elderly who have already suffered from cognitive impairment, VD supplementation may also be beneficial for their brains.
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25
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Burkhardt R. Vitamin D: review of physiology and clinical uses. Minerva Endocrinol (Torino) 2023; 48:88-105. [PMID: 36920117 DOI: 10.23736/s2724-6507.22.03652-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Interest in vitamin D has increased within the scientific community due to the impact of osteoporosis in the aging population. Vitamin D receptors are present in many tissues and low vitamin D status has been associated with many diseases in observational studies. There was hope that enhanced vitamin D provision might help prevent and treat some widespread disorders. Some of these hopes have been refuted by the results of recent large and well-conducted randomized trials. This review provides an overview of the basic physiology of vitamin D and an update on the evidence base for its clinical applications.
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26
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Stephan Y, Sutin AR, Luchetti M, Aschwanden D, Terracciano A. The mediating role of Vitamin D in the association between personality and memory: Evidence from two samples. Biol Psychol 2023; 178:108525. [PMID: 36806675 PMCID: PMC10106409 DOI: 10.1016/j.biopsycho.2023.108525] [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: 07/24/2022] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 02/21/2023]
Abstract
Five-Factor Model (FFM) personality traits are consistently related to cognition in old age. However, little is known about the biological mediators of this association. The present study examined whether levels of Vitamin D mediated the association between personality and memory. Participants were adults aged 50-96 years from the Health and Retirement Study (HRS, N = 5229) and the English Longitudinal Study of Ageing (ELSA, N = 4249). In HRS, personality and demographic factors were assessed in 2012/2014, Vitamin D was assessed in 2016, and memory was assessed in 2018. In ELSA, personality and demographic factors were obtained in 2010/2011, Vitamin D was measured in 2012/2013, and memory was assessed in 2014/2015. In both samples, higher extraversion and conscientiousness were related to higher levels of Vitamin D, whereas higher neuroticism was related to lower Vitamin D. In both samples, higher Vitamin D partly mediated the association between both higher extraversion and conscientiousness and better memory. The association between higher neuroticism and worse memory at follow-up was partially mediated by lower Vitamin D in the HRS and ELSA. Vitamin D did not mediate the association between higher openness and better memory. The present study extends the personality-cognition literature by providing new replicable evidence that Vitamin D is a biological mediator.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, USA
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, USA
| | - Damaris Aschwanden
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland; Department of Geriatrics, College of Medicine, Florida State University, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, USA
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27
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Wang W, Li Y, Meng X. Vitamin D and neurodegenerative diseases. Heliyon 2023; 9:e12877. [PMID: 36820164 PMCID: PMC9938420 DOI: 10.1016/j.heliyon.2023.e12877] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/23/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
Neurodegenerative diseases, featured by progressive loss of structure or function of neurons, are considered incurable at present. Movement disorders like tremor and postural instability, cognitive or behavioral disorders such as memory impairment are the most common symptoms of them and the growing patient population of neurodegenerative diseases poses a serious threat to public health and a burden on economic development. Hence, it is vital to prevent the occurrence of the diseases and delay their progress. Vitamin D can be transformed into a hormone in vivo with both genomic and non-genomic actions, exerting diverse physiological effects. Cumulative evidence indicates that vitamin D can ameliorate neurodegeneration by regulating pertinent molecules and signaling pathways including maintaining Ca2+ homeostasis, reducing oxidative stress, inhibiting inflammation, suppressing the formation and aggregation of the pathogenic protein, etc. This review updates discoveries of molecular mechanisms underlying biological functions of vitamin D in neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and vascular dementia. Clinical trials investigating the influence of vitamin D supplementation in patients with neurodegenerative diseases are also summarized. The synthesized information will probably provoke an enhanced understanding of the neuroprotective roles of vitamin D in the nervous system and provide therapeutic options for patients with neurodegenerative diseases in the future.
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28
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Gombart AF, Michels AJ, Eggersdorfer M. There is no evidence that vitamin D supplementation drives the progression of Alzheimer's disease. Aging Cell 2022; 22:e13758. [PMID: 36533447 PMCID: PMC9835569 DOI: 10.1111/acel.13758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Adrian F. Gombart
- Department of Biochemistry and Biophysics, Linus Pauling InstituteOregon State UniversityCorvallisOregonUSA
| | | | - Manfred Eggersdorfer
- Department of Internal MedicineUniversity Medical Center GroningenGroningenThe Netherlands
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29
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Cui X, Eyles DW. Vitamin D and the Central Nervous System: Causative and Preventative Mechanisms in Brain Disorders. Nutrients 2022; 14:nu14204353. [PMID: 36297037 PMCID: PMC9610817 DOI: 10.3390/nu14204353] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Twenty of the last one hundred years of vitamin D research have involved investigations of the brain as a target organ for this hormone. Our group was one of the first to investigate brain outcomes resulting from primarily restricting dietary vitamin D during brain development. With the advent of new molecular and neurochemical techniques in neuroscience, there has been increasing interest in the potential neuroprotective actions of vitamin D in response to a variety of adverse exposures and how this hormone could affect brain development and function. Rather than provide an exhaustive summary of this data and a listing of neurological or psychiatric conditions that vitamin D deficiency has been associated with, here, we provide an update on the actions of this vitamin in the brain and cellular processes vitamin D may be targeting in psychiatry and neurology.
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Affiliation(s)
- Xiaoying Cui
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol Q4076, Australia
- Queensland Brain Institute, University of Queensland, St Lucia Q4076, Australia
| | - Darryl W. Eyles
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol Q4076, Australia
- Queensland Brain Institute, University of Queensland, St Lucia Q4076, Australia
- Correspondence:
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30
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Targeted Mitochondrial Epigenetics: A New Direction in Alzheimer’s Disease Treatment. Int J Mol Sci 2022; 23:ijms23179703. [PMID: 36077101 PMCID: PMC9456144 DOI: 10.3390/ijms23179703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/19/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Mitochondrial epigenetic alterations are closely related to Alzheimer’s disease (AD), which is described in this review. Reports of the alteration of mitochondrial DNA (mtDNA) methylation in AD demonstrate that the disruption of the dynamic balance of mtDNA methylation and demethylation leads to damage to the mitochondrial electron transport chain and the obstruction of mitochondrial biogenesis, which is the most studied mitochondrial epigenetic change. Mitochondrial noncoding RNA modifications and the post-translational modification of mitochondrial nucleoproteins have been observed in neurodegenerative diseases and related diseases that increase the risk of AD. Although there are still relatively few mitochondrial noncoding RNA modifications and mitochondrial nuclear protein post-translational modifications reported in AD, we have reason to believe that these mitochondrial epigenetic modifications also play an important role in the AD process. This review provides a new research direction for the AD mechanism, starting from mitochondrial epigenetics. Further, this review summarizes therapeutic approaches to targeted mitochondrial epigenetics, which is the first systematic summary of therapeutic approaches in the field, including folic acid supplementation, mitochondrial-targeting antioxidants, and targeted ubiquitin-specific proteases, providing a reference for therapeutic targets for AD.
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Vitamin D Status and Parkinson's Disease. Brain Sci 2022; 12:brainsci12060790. [PMID: 35741675 PMCID: PMC9221008 DOI: 10.3390/brainsci12060790] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023] Open
Abstract
Parkinson’s disease (PD) is a complex and progressive neurodegenerative disease, characterized by resting tremor, rigidity, slowness of movement, and postural instability. Furthermore, PD is associated with a wide spectrum of non-motor symptoms that add to overall disability. In recent years, some investigations, from basic science to clinical applications, have focused on the role of vitamin D in PD, often with controversial findings. Vitamin D has widespread effects on several biological processes in the central nervous system, including neurotransmission in dopaminergic neural circuits. Various studies have recorded lower levels of vitamin D in PD patients than in healthy controls. Low vitamin D status has also been correlated with the risk for PD and motor severity, whereas less is known about the effects vitamin D has on cognitive function and other non-motor symptoms. This review aims to better characterize the correlation between vitamin D and PD, clarify the role of vitamin D in PD prevention and treatment, and discuss avenues for future research in this field.
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Kang JH, Vyas CM, Okereke OI, Ogata S, Albert M, Lee I, D'Agostino D, Buring JE, Cook NR, Grodstein F, Manson JE. Marine n-3 fatty acids and cognitive change among older adults in the VITAL randomized trial. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12288. [PMID: 35415212 PMCID: PMC8984093 DOI: 10.1002/trc2.12288] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 12/19/2022]
Abstract
Introduction : Few large, randomized trials have evaluated marine n-3 supplements and cognition in healthy older adults. Methods : Healthy community-dwelling participants aged 60+ years (mean [standard deviation] = 70.9 [5.8] years) in VITAL (randomized trial of n-3 fats [1 g/day, including 840 mg of eicosapentaenoic acid + docosahexaenoic acid] and vitamin D) were included: 3424 whose cognition was assessed by phone (VITAL-Cog; eight neuropsychological tests; 2.8 years) and 794 evaluated in person (CTSC-Cog; nine tests; 2.0 years). The primary outcome was a global score (average of test z-scores) of change over two assessments. We used multivariable-adjusted linear mixed models; substudy-specific results were meta-analyzed. Results : We observed no significant effect of n-3 supplementation: the mean difference in annual rate of cognitive change for the n-3 versus placebo group was -0.01 standard units (95% confidence interval [CI]: -0.02, 0.003) in VITAL-Cog and -0.002 (95% CI: -0.04, 0.03) in CTSC-Cog; the pooled difference was -0.01 (95% CI: -0.02, 0.003; P = .15). Discussion : Marine n-3 supplementation (1 g/day) did not confer cognitive benefits over 2 to 3 years in community-dwelling older adults.
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Affiliation(s)
- Jae H. Kang
- Channing Division of Network MedicineBrigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Chirag M. Vyas
- Department of PsychiatryMassachusetts General Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Olivia I. Okereke
- Channing Division of Network MedicineBrigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryMassachusetts General Hospital/Harvard Medical SchoolBostonMassachusettsUSA
- Department of EpidemiologyHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
| | - Soshiro Ogata
- Department of Preventive Medicine and EpidemiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Michelle Albert
- University of California at San Francisco School of MedicineSan FranciscoCaliforniaUSA
| | - I‐Min Lee
- Department of EpidemiologyHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
- Division of Preventive MedicineBrigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Denise D'Agostino
- Division of Preventive MedicineBrigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Julie E. Buring
- Division of Preventive MedicineBrigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Nancy R. Cook
- Department of EpidemiologyHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
- Division of Preventive MedicineBrigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Francine Grodstein
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - JoAnn E. Manson
- Department of EpidemiologyHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
- Division of Preventive MedicineBrigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
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Gil Martínez V, Avedillo Salas A, Santander Ballestín S. Vitamin Supplementation and Dementia: A Systematic Review. Nutrients 2022; 14:1033. [PMID: 35268010 PMCID: PMC8912288 DOI: 10.3390/nu14051033] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Dementia is a syndrome characterized by progressive cognitive impairment that interferes with independent function in daily activities. Symptoms of dementia depend on its cause and vary greatly between individuals. There is extensive evidence supporting a relationship between diet and cognitive functions. This systematic review studies the efficacy of using vitamin supplements in the diet as a solution to nutritional deficiencies and the prevention of dementia and mild cognitive impairment. METHODS An intensive search of different databases (PubMed, Web of Science, and Cochrane CENTRAL) was performed. Articles that were published between 2011 and November 2021 were retrieved using the mentioned search strategy. This systematic review has been conducted according to the PRISMA statement. RESULTS Folic acid supplementation proved to have better outcomes on cognitive tests than their respective control groups. The combined supplementation of folic acid and vitamin B12 showed some discrepancies between studies. Thiamine as supplementation did not only prove to have a positive impact on cognitive performance when given alone but also when given in combination with folic acid. Regarding vitamin D supplementation, the results observed were not so encouraging. A concomitant supplementation of low-dose vitamin E and vitamin C was also not associated with an improvement of cognitive function. CONCLUSIONS The findings of this systematic review suggest that supplementation of B Complex vitamins, especially folic acid, may have a positive effect on delaying and preventing the risk of cognitive decline. Ascorbic acid and a high dose of vitamin E, when given separately, also showed positive effects on cognitive performance, but there is not sufficient evidence to support their use. The results of vitamin D supplementation trials are not conclusive in assessing the potential benefits that vitamin D might have on cognition.
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Affiliation(s)
| | - Ana Avedillo Salas
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Sonia Santander Ballestín
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain;
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