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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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2
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Zhang J, Zhang A. Association between serum 25-hydroxyvitamin D3 level and cognitive impairment in older chronic kidney disease patients. Sci Rep 2024; 14:12403. [PMID: 38811765 PMCID: PMC11137016 DOI: 10.1038/s41598-024-63350-y] [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: 09/11/2023] [Accepted: 05/28/2024] [Indexed: 05/31/2024] Open
Abstract
This study aims to examine whether hypovitaminosis D was associated with cognitive impairment among chronic kidney patients with different level of albuminuria. This population-based cross-sectional study was conducted on elderly (over 60 years old) with urine albumin to creatinine ratio (UACR) ≥ 30 mg/g from 2011 to 2014 in the US National Health and Nutrition Examination Survey (NHANES). Cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer's Disease Word List Learning (CERAD). Subjects were divided into 2 groups according to the absence or presence of cognitive impairment and a propensity score matching (PSM) was further conducted. The association was assessed with Spearman correlation and logistic regression analysis. The positive association of 25-hydroxyvitamin D3 (25(OH)D3) and cognitive score was presented. PSM analysis revealed that a higher level of 25(OH)D3 correlated to a better cognitive function in CKD patients with albuminuria, especially in patients with 30 mg/g ≤ UACR < 300 mg/g. This study indicated that a low 25(OH)D3 level was associated with poor cognitive performance, especially in patients with microalbuminuria. Thus, early diagnosis of vitamin D insufficiency and an effective intervention might be a useful therapeutic strategy to prevent cognitive decline in patients with the progression of renal dysfunction.
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Affiliation(s)
- Jialing Zhang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Aihua Zhang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China.
- The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing, China.
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3
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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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Liu J, Roccati E, Chen Y, Zhu Z, Wang W, He M, Shang X. Seasonal Variations in Vitamin D Levels and the Incident Dementia Among Older Adults Aged ≥60 Years in the UK Biobank. J Alzheimers Dis Rep 2024; 8:411-422. [PMID: 38549631 PMCID: PMC10977452 DOI: 10.3233/adr-230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/17/2024] [Indexed: 05/16/2024] Open
Abstract
Background Limited knowledge exists regarding the association between dementia incidence and vitamin D insufficiency/deficiency across seasons. Objective This study aimed to evaluate the impact of seasonal serum vitamin D (25(OH)D) levels on dementia and its subtypes, considering potential modifiers. Methods We analyzed 193,003 individuals aged 60-73 at baseline (2006-2010) from the UK Biobank cohort, with follow-up until 2018. 25(OH)D were measured at baseline, and incident dementia cases were identified through hospital records, death certificates, and self-reports. Results Out of 1,874 documented all-cause dementia cases, the median follow-up duration was 8.9 years. Linear and nonlinear associations between 25(OH)D and dementia incidence across seasons were observed. In multivariable-adjusted analysis, 25(OH)D deficiency was associated with a 1.5-fold (95% CIs: 1.2-2.0), 2.2-fold (1.5-3.0), 2.0-fold (1.5-2.7), and 1.7-fold (1.3-2.3) increased incidence of all-cause dementia in spring, summer, autumn, and winter, respectively. Adjusting for seasonal variations, 25(OH)D insufficiency and deficiency were associated with a 1.3-fold (1.1-1.4) and 1.8-fold (1.6-2.2) increased dementia incidence, respectively. This association remained significant across subgroups, including baseline age, gender, and education levels. Furthermore, 25(OH)D deficiency was associated with a 1.4-fold (1.1-1.8) and 1.5-fold (1.1-2.0) higher incidence of Alzheimer's disease and vascular dementia, respectively. These associations remained significant across all subgroups. Conclusions 25(OH)D deficiency is associated with an increased incidence of dementia and its subtypes throughout the year.
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Affiliation(s)
- Jiahao Liu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Eddy Roccati
- Wicking Dementia Research and Education Centre, University of Tasmania, TAS, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Yutong Chen
- Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
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Shea MK, 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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Plantone D, Pardini M, Caneva S, De Stefano N. Is There a Role of Vitamin D in Alzheimer's Disease? CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:545-553. [PMID: 37246320 DOI: 10.2174/1871527322666230526164421] [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: 01/05/2023] [Revised: 04/05/2023] [Accepted: 04/19/2023] [Indexed: 05/30/2023]
Abstract
Alzheimer's disease (AD) represents the most prevalent type of neurodegenerative dementia and the sixth leading cause of death worldwide. The so-called "non-calcemic actions" of vitamin D have been increasingly described, and its insufficiency has already been linked to the onset and progression of the main neurological diseases, including AD. Immune-mediated Aβ plaque's phagocytosis and clearance, immune response, oxidative stress, and mitochondrial function are all influenced by vitamin D, and these functions are considered relevant in AD pathogenesis. However, it has been shown that the genomic vitamin D signaling pathway is already impaired in the AD brain, making things more complicated. In this paper, we aim to summarise the role of vitamin D in AD and review the results of the supplementation trials in AD patients.
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Affiliation(s)
- Domenico Plantone
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Stefano Caneva
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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7
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Zhang XX, Wang HR, Meng-Wei, Hu YZ, Sun HM, Feng YX, Jia JJ. Association of Vitamin D Levels with Risk of Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis of Prospective Studies. J Alzheimers Dis 2024; 98:373-385. [PMID: 38461506 DOI: 10.3233/jad-231381] [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: 03/12/2024]
Abstract
Background Emerging evidence suggests the potential relationship between vitamin D deficiency and risk of cognitive impairment or dementia. To what extent the excess risk of dementia conferred by vitamin D deficiency is less clear. Objective We summarized the current evidence from several aspects and further quantified these associations. Methods We collected relevant prospective cohort studies by searching PubMed, Embase and Cochrane up to July 2023. The pooled relative risks (RR) were evaluated by random-effects models. Dose-response analyses were conducted by the method of two-stage generalized least squares regression. Results Of 9,267 identified literatures, 23 were eligible for inclusion in the meta-analyses, among which 9 and 4 literatures were included in the dose-response analyses for the risk of dementia and Alzheimer's disease (AD). Vitamin D deficiency exhibited a 1.42 times risk for dementia (95% confidence interval (CI) = 1.21-1.65) and a 1.57-fold excess risk for AD (95% CI = 1.15-2.14). And vitamin D deficiency was associated with 34% elevated risk with cognitive impairment (95% CI = 1.19-1.52). Additionally, vitamin D was non-linearly related to the risk of dementia (pnonlinearity = 0.0000) and AD (pnonlinearity = 0.0042). The approximate 77.5-100 nmol/L 25-hydroxyvitamin D [25(OH)D] was optimal for reducing dementia risk. And the AD risk seemed to be decreased when the 25(OH)D level >40.1 nmol/L. Conclusions Vitamin D deficiency was a risk factor for dementia, AD, and cognitive impairment. The nonlinear relationships may further provide the optimum dose of 25(OH)D for dementia prevention.
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Affiliation(s)
- Xiao-Xue Zhang
- Medical School of Chinese People's Liberation Army, Beijing, China
- Institute of Geriatrics, The 2nd Medical Center, China National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - He-Ran Wang
- Institute of Geriatrics, The 2nd Medical Center, China National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Meng-Wei
- Institute of Geriatrics, The 2nd Medical Center, China National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ya-Zhuo Hu
- Institute of Geriatrics, The 2nd Medical Center, China National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hong-Mei Sun
- Medical School of Chinese People's Liberation Army, Beijing, China
- Institute of Geriatrics, The 2nd Medical Center, China National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yu-Xin Feng
- Medical School of Chinese People's Liberation Army, Beijing, China
- Institute of Geriatrics, The 2nd Medical Center, China National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jian-Jun Jia
- Medical School of Chinese People's Liberation Army, Beijing, China
- Institute of Geriatrics, The 2nd Medical Center, China National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
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8
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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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9
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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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10
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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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11
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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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12
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Anwar MJ, Alenezi SK, Alhowail AH. Molecular insights into the pathogenic impact of vitamin D deficiency in neurological disorders. Biomed Pharmacother 2023; 162:114718. [PMID: 37084561 DOI: 10.1016/j.biopha.2023.114718] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023] Open
Abstract
Neurological disorders are the major cause of disability, leading to a decrease in quality of life by impairing cognitive, sensorimotor, and motor functioning. Several factors have been proposed in the pathogenesis of neurobehavioral changes, including nutritional, environmental, and genetic predisposition. Vitamin D (VD) is an environmental and nutritional factor that is widely distributed in the central nervous system's subcortical grey matter, neurons of the substantia nigra, hippocampus, thalamus, and hypothalamus. It is implicated in the regulation of several brain functions by preserving neuronal structures. It is a hormone rather than a nutritional vitamin that exerts a regulatory role in the pathophysiology of several neurological disorders, including Alzheimer's disease, Parkinson's disease, epilepsy, and multiple sclerosis. A growing body of epidemiological evidence suggests that VD is critical in neuronal development and shows neuroprotective effects by influencing the production and release of neurotrophins, antioxidants, immunomodulatory, regulation of intracellular calcium balance, and direct effect on the growth and differentiation of nerve cells. This review provides up-to-date and comprehensive information on vitamin D deficiency, risk factors, and clinical and preclinical evidence on its relationship with neurological disorders. Furthermore, this review provides mechanistic insight into the implications of vitamin D and its deficiency on the pathogenesis of neurological disorders. Thus, an understanding of the crucial role of vitamin D in the neurobiology of neurodegenerative disorders can assist in the better management of vitamin D-deficient individuals.
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Affiliation(s)
- Md Jamir Anwar
- Department of Pharmacology and Toxicology, Unaizah College of Pharmacy, Qassim University, Qassim, Unaizah 51911, Saudi Arabia
| | - Sattam Khulaif Alenezi
- Department of Pharmacology and Toxicology, Unaizah College of Pharmacy, Qassim University, Qassim, Unaizah 51911, Saudi Arabia.
| | - Ahmad Hamad Alhowail
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Qassim, Buraydah 51452, Saudi Arabia
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13
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The Vitamin D Receptor as a Potential Target for the Treatment of Age-Related Neurodegenerative Diseases Such as Alzheimer's and Parkinson's Diseases: A Narrative Review. Cells 2023; 12:cells12040660. [PMID: 36831327 PMCID: PMC9954016 DOI: 10.3390/cells12040660] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The vitamin D receptor (VDR) belongs to the nuclear receptor superfamily of transcription factors. The VDR is expressed in diverse brain regions and has been implicated in the neuroprotective, antiaging, prosurvival, and anti-inflammatory action of vitamin D. Accordingly, a relationship between vitamin D insufficiency and susceptibility to neurodegenerative diseases has been suggested. However, due to the multitargeted mechanisms of vitamin D and its often overlapping genomic and nongenomic effects, the role of the VDR in brain pathologies remains obscure. In this narrative review, we present progress in deciphering the molecular mechanism of nuclear VDR-mediated vitamin D effects on prosurvival and anti-inflammatory signaling pathway activity within the central nervous system. In line with the concept of the neurovascular unit in pathomechanisms of neurodegenerative diseases, a discussion of the role of the VDR in regulating the immune and vascular brain systems is also included. Next, we discuss the results of preclinical and clinical studies evaluating the significance of vitamin D status and the efficacy of vitamin D supplementation in the treatment of Parkinson's and Alzheimer's diseases, emphasizing the possible role of the VDR in these phenomena. Finally, the associations of some VDR polymorphisms with higher risks and severity of these neurodegenerative disorders are briefly summarized.
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14
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Li T, Chen C, Yuan J, Zhang K, Zhang M, Zhao H, Wu X, Zhu L, Huang G, Ma F. The Association between Vitamin D Deficiency and Changes in Cognitive Functions in Chinese Older Adults: A Prospective Cohort Study. Curr Alzheimer Res 2023; 20:506-514. [PMID: 37957919 DOI: 10.2174/0115672050266769231025060359] [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: 06/12/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Along with the problem of population aging, the prevalence of dementia is gradually increasing. Associations between vitamin D deficiency (VDD) and cognitive functions remain unclear. OBJECTIVES We aimed to determine the relationship between VDD and changes in cognitive performance in community-dwelling older adults. METHODS In this longitudinal cohort study, participants aged ≥65 years were enrolled in March, 2016. The serum level of 25-hydroxy-vitamin D was analyzed by liquid-chromatography-tandem-- mass-spectrometry at baseline. VDD was defined as less than 20 ng/mL. All participants completed a health status questionnaire. Cognitive functions were evaluated by the Wechsler Adult Intelligence Scale-Revised in China at baseline and each visit. The linear mixed-effects model was utilized to examine the association between baseline VDD and changes in cognitive functions. RESULTS In total, 866 participants were included in our study, with a mean duration of 3 years. VDD was markedly associated with lower full intelligence quotient (FIQ) (β: -3.355, 95% confidence interval [CI]:-4.165,-2.545), verbal intelligence quotient (VIQ) (β: -3.420, 95%CI: -4.193,-2.647), performance intelligence quotient (PIQ) (β: -2.610, 95%CI: -3.683,-1.537), comprehension (β: -0.630, 95%CI: -1.022,-0.238), information (β: -0.354, 95%CI: -0.699,-0.008), arithmetic (β: -1.065, 95%CI: -1.228,-0.902), digit span (β: -0.370, 95%CI: -0.547,-0.192), vocabulary (β: -0.789, 95%CI: -1.084,-0.493), picture completion (β: -0.391, 95%CI: -0.761,-0.022), block design (β: -0.412, 95%CI: -0.697,-0.127), picture arrangement (β: -0.542, 95%CI: -0.909,-0.174), and object assembly (β: -0.492, 95%CI: -0.818,-0.165) than those with adequacy. CONCLUSION A higher frequency of VDD was associated with lower scores of FIQ, VIQ, PIQ and subtests on memory and executive function. Future randomized controlled trials are warranted to further verify the conclusions.
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Affiliation(s)
- Tongtong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Chong Chen
- Department of Clinical Laboratory, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, National Human Genetic Resources Sharing Service Platform, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China
| | - Jing Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Keming Zhang
- Department of Nutrition, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300073, China
| | - Meilin Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Huichao Zhao
- Department of Medicine and Humanities, Tianjin Medical University, Tianjin, 300070, China
| | - Xiaomin Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Liping Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Fei Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, 300070, China
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15
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Asante EO, Mai XM, Eldholm RS, Skjellegrind HK, Kolberg M, Brumpton BM, Selbæk G, Chen Y, Sun YQ. Vitamin D Status Over Time and Cognitive Function in Norwegian Older Adults: A Prospective Cohort of the HUNT Study. J Nutr Health Aging 2023; 27:30-37. [PMID: 36651484 DOI: 10.1007/s12603-022-1867-8] [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: 12/13/2022]
Abstract
BACKGROUND There is conflicting evidence regarding the association between vitamin D status and cognitive function in population studies. The use of one-time vitamin D measurement in cognitive health studies may not reflect long-term vitamin D status in the body. OBJECTIVE We aimed to examine the relationship of vitamin D status measured over time with the risk of neurocognitive disorders (NCDs) in Norwegian older adults. DESIGN Prospective cohort study. SETTING Regional, Trøndelag Health Study. PARTICIPANTS This study followed a random cohort of 717 participants from HUNT2 (1995-97) and HUNT3 (2006-08) to HUNT4 70+ (2017-19). The mean age at HUNT4 70+ was 77.7 years. METHODS Seasonal-standardized serum 25-hydroxyvitamin D [25(OH)D] levels in HUNT2 and HUNT3 were averaged and used as either a categorical variable (<50 and ≥50 nmol/L) or a continuous variable (per 25 nmol/L decrease). In the cohort aged 70 years or over (HUNT4 70+), NCDs consisting of mild cognitive impairment (MCI) and dementia were diagnosed by clinical experts according to the DSM-5 criteria. Logistic and linear regression models were used to estimate odds ratios (ORs) and regression coefficients (beta) with 95% confidence intervals (CIs) to assess the relationship between 25(OH)D levels and the risk of NCDs or the Montreal Cognitive Assessment (MoCA) score. RESULTS In total, 347 (48.4%) had NCDs in HUNT4, with 33.3% having MCI and 15.1% having dementia. Compared with participants with serum 25(OH)D ≥50 nmol/L, those with 25(OH)D <50 nmol/L had a similar risk of NCDs (OR 1.05, 95% CI 0.76 to 1.46). No association was observed with the risk of MCI (OR 1.01, 95% CI 0.71 to 1.44) or dementia (OR 1.16, 95% CI 0.70 to 1.92), respectively. In a subsample of participants evaluated with the MoCA (n=662), a 25 nmol/L decrease in serum 25(OH)D was not associated with a change in MoCA score (beta 0.33, 95% CI -0.17 to 0.85). CONCLUSION Vitamin D insufficiency defined by two times measurements of serum 25(OH)D with a 10-year interval was not associated with the risk of NCDs in a cohort of older Norwegian adults. Future studies utilizing multiple vitamin D measurements with a longer follow-up duration and larger sample size are warranted.
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Affiliation(s)
- E O Asante
- Ernest Obeng Asante, Norwegian University of Science and Technology, Trondheim, Sor-Trondelag, Norway,
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16
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Low Serum Vitamin D Status Is Associated with Incident Alzheimer's Dementia in the Oldest Old. Nutrients 2022; 15:nu15010061. [PMID: 36615719 PMCID: PMC9824107 DOI: 10.3390/nu15010061] [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: 11/23/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background. Vitamins A, D and E and beta-carotene may have a protective function for cognitive health, due to their antioxidant capacities. Methods. We analyzed data from 1334 non-demented participants (mean age 84 years) from the AgeCoDe study, a prospective multicenter-cohort of elderly general-practitioner patients in Germany, of whom n = 250 developed all-cause dementia and n = 209 developed Alzheimer’s dementia (AD) during 7 years of follow-up. We examined whether concentrations of vitamins A (retinol), D (25-hydroxycholecalciferol) and E (alpha-tocopherol) and beta-carotene, would be associated with incident (AD) dementia. Results. In our sample, 33.7% had optimum vitamin D concentrations (≥50 nmol/L). Higher concentrations of vitamin D were associated with lower incidence of all-cause dementia and AD (HR 0.99 (95%CI 0.98; 0.99); HR0.99 (95%CI 0.98; 0.99), respectively). In particular, subjects with vitamin D deficiency (25.3%, <25 nmol/L) were at increased risk for all-cause dementia and AD (HR1.91 (95%CI 1.30; 2.81); HR2.28 (95%CI 1.47; 3.53), respectively). Vitamins A and E and beta-carotene were unrelated to (AD) dementia. Conclusions. Vitamin D deficiency increased the risk to develop (AD) dementia. Our study supports the advice for monitoring vitamin D status in the elderly and vitamin D supplementation in those with vitamin D deficiency. We observed no relationships between the other vitamins with incident (AD) dementia, which is in line with previous observational studies.
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17
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Uthaiah CA, Devaru NC, Shivakumar NH, R R, Madhunapantula SV. Vitamin D Mitigates Hyperglycemia-Induced Cognition Decline in Danio rerio (Zebrafish) through the Activation of Antioxidant Mechanisms. Antioxidants (Basel) 2022; 11:antiox11112114. [PMID: 36358486 PMCID: PMC9686813 DOI: 10.3390/antiox11112114] [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: 10/02/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022] Open
Abstract
Hyperglycemia contributes to the development of cognition impairment and related disorders, induces oxidative stress in neuronal cells; thereby, impairs normal signaling mechanisms involved in cognition processes. Studies have shown a significant decrease in the vitamin D in individuals with hyperglycemia and cognition impairment. But whether supplementing vitamin D has any beneficiary impact on mitigating hyperglycemia-induced cognition impairment is unknown. We have first tested the impact of hyperglycemia on the induction of cognition deficiency in a zebrafish model. Next, the molecular mechanisms related to oxidative stress, which are deregulated in hyperglycemic zebrafish brains, have been explored. Subsequently, the impact of supplementing the water with vitamin D and a known activator of nuclear factor erythroid-2 related factor 2 (Nrf2) i.e., sulforaphane (SFN) on learning and memory functions were assessed. We showed a significant increase in the oxidative stress in the brain tissue of zebrafish residing in hyperglycemic water (111 mM glucose). Addition of vitamin D and SFN increased Nrf2, but differentially modulated its target genes (NQO1, SOD, GPx etc) activity in zebrafish and neuronal cell lines thereby improved the hyperglycemia-induced decline of cognition impairment. Mechanistically, vitamin D binds to the Keap1 protein; thereby, interfering with its binding to Nrf2, which leads to the activation of antioxidant mechanisms in the cells. In summary, reducing the oxidative stress through vitamin D treatment is a possible option for controlling the cognition impairment in diabetic population, but studies testing this possibility in clinical trials are currently needed.
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Affiliation(s)
- Chinnappa A Uthaiah
- Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College; JSS Academy of Higher Education & Research, Mysuru 570015, India
| | - Nandini C Devaru
- Department of Pharmacology, JSS College of Pharmacy; JSS Academy of Higher Education & Research, Mysuru 570015, India
| | - Nandini H Shivakumar
- Department of Pharmacology, JSS College of Pharmacy; JSS Academy of Higher Education & Research, Mysuru 570015, India
| | - Rajalakshmi R
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru 570015, India
| | - SubbaRao V Madhunapantula
- Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College; JSS Academy of Higher Education & Research, Mysuru 570015, India
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18
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Grant WB, Boucher BJ, Al Anouti F, Pilz S. Comparing the Evidence from Observational Studies and Randomized Controlled Trials for Nonskeletal Health Effects of Vitamin D. Nutrients 2022; 14:nu14183811. [PMID: 36145186 PMCID: PMC9501276 DOI: 10.3390/nu14183811] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 12/12/2022] Open
Abstract
Although observational studies of health outcomes generally suggest beneficial effects with, or following, higher serum 25-hydroxyvitamin D [25(OH)D] concentrations, randomized controlled trials (RCTs) have generally not supported those findings. Here we review results from observational studies and RCTs regarding how vitamin D status affects several nonskeletal health outcomes, including Alzheimer’s disease and dementia, autoimmune diseases, cancers, cardiovascular disease, COVID-19, major depressive disorder, type 2 diabetes, arterial hypertension, all-cause mortality, respiratory tract infections, and pregnancy outcomes. We also consider relevant findings from ecological, Mendelian randomization, and mechanistic studies. Although clear discrepancies exist between findings of observational studies and RCTs on vitamin D and human health benefits these findings should be interpreted cautiously. Bias and confounding are seen in observational studies and vitamin D RCTs have several limitations, largely due to being designed like RCTs of therapeutic drugs, thereby neglecting vitamin D’s being a nutrient with a unique metabolism that requires specific consideration in trial design. Thus, RCTs of vitamin D can fail for several reasons: few participants’ having low baseline 25(OH)D concentrations, relatively small vitamin D doses, participants’ having other sources of vitamin D, and results being analyzed without consideration of achieved 25(OH)D concentrations. Vitamin D status and its relevance for health outcomes can usefully be examined using Hill’s criteria for causality in a biological system from results of observational and other types of studies before further RCTs are considered and those findings would be useful in developing medical and public health policy, as they were for nonsmoking policies. A promising approach for future RCT design is adjustable vitamin D supplementation based on interval serum 25(OH)D concentrations to achieve target 25(OH)D levels suggested by findings from observational studies.
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA 94164-1603, USA
- Correspondence:
| | - Barbara J. Boucher
- The London School of Medicine and Dentistry, The Blizard Institute, Barts, Queen Mary University of London, London E1 2AT, UK
| | - Fatme Al Anouti
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab Emirates
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
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Lin J, Niu Z, Xue Y, Gao J, Zhang M, Li M, Peng Y, Zhang S, Li W, Zhang Q, Li X. Chronic vitamin D 3 supplementation alleviates cognition impairment via inhibition of oxidative stress regulated by PI3K/AKT/Nrf2 in APP/PS1 transgenic mice. Neurosci Lett 2022; 783:136725. [PMID: 35697158 DOI: 10.1016/j.neulet.2022.136725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022]
Abstract
Oxidative stress plays essential role in the pathogenesis of Alzheimer's disease, and vitamin D3 (VD3) is a nutrient with neuroprotective and antioxidant activities. The present study aimed to confirm the neuroprotective effect and the ameliorative effect of cortical oxidative stress of VD3 in APP/PS1 transgenic mice. APP/PS1 mice were treated with VD3 for 20 weeks. After treatment, Morris Water Maze test was used to evaluate cognitive level. Western blotting was used to determine APP, p-tau, tau and PI3K/AKT/Nrf2 pathway-related protein expression levels. Immunohistochemical staining was performed to determine the levels of β amyloid peptide (Aβ) deposition. Enzyme linked immunosorbent assay was used to determine the 25(OH)D3 levels and oxidative stress status. Our results showed that treatment with VD3 ameliorated behavioral deficits of APP/PS1 mice. In addition, the administration of VD3 significantly increased the cortical 25(OH)D3 levels, while reducing the levels of cortical Aβ deposition and decreasing the expression levels of cortical APP, tau and p-tau in APP/PS1 mice. Moreover, VD3 protected the cortex against oxidative stress by enhancing the levels of superoxide dismutase, glutathione and total antioxidant capacity, and downregulating the malondialdehyde levels. Furthermore, VD3 clearly activated the PI3K/AKT/Nrf2 pathway, thereby elevating the expression levels of HO1 and NQO1. We concluded that VD3 improved cognitive function and cortical Alzheimer-like pathology of APP/PS1 mice, which may be related to the inhibition of oxidative stress via activation the PI3K/AKT/Nrf2 pathway.
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Affiliation(s)
- Jisong Lin
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Zhuoya Niu
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Yuan Xue
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Jiaojiao Gao
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Mimi Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Mengxin Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Yangyang Peng
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Shenshen Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Qian Zhang
- Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Xing Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
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20
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Thaipisuttikul P, Jaikla K, Satthong S, Wisajun P. Rate of conversion from mild cognitive impairment to dementia in a Thai hospital-based population: A retrospective cohort. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12272. [PMID: 35386122 PMCID: PMC8970424 DOI: 10.1002/trc2.12272] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 02/05/2023]
Abstract
Introduction Mild cognitive impairment (MCI) is the state between normal cognition and dementia. This study objective was to estimate an average 1-year rate of conversion from MCI to dementia and explore the associated factors of conversion in a hospital-based cohort. Methods A retrospective cohort study of participants with MCI was conducted in a tertiary care hospital in Thailand. Two hundred fifty participants, 50 years of age or older, were enrolled. Results An average 1-year conversion rate from MCI to dementia was 18.4%. MCI patients who converted to dementia were likely older (P < .001), predominantly female (P = .028), vitamin D deficient (P = .012), and associated with lower Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores during first assessments (P < .001, P < .001 respectively) and follow-up assessments (P < .045, P < .001 respectively). We conducted two models of multivariate analysis, using binary logistic regression. In the first model, adjusted for age, sex, education, vitamin D deficiency, and first assessment MMSE scores, we found that underlying vitamin D deficiency (odds ratio [OR] = 3.13, 95% confidence interval [CI] 1.04 to 9.44) and first assessment MMSE scores (OR = 0.83, 95% CI 0.73 to 0.93) were significantly associated with conversion to dementia. In the second model, adjusted for age, sex, education, vitamin D deficiency and first assessment MoCA scores, only first assessment MoCA scores (OR = 0.58, 95% CI 0.45 to 0.76) were significantly associated with conversion to dementia. Discussion The 1-year conversion rate from MCI to dementia was 18.4%. MMSE and MoCA were useful tools to assess baseline cognitive status in MCI patients and predict dementia progression. The association between vitamin D deficiency and risk of conversion from MCI to dementia requires further investigations.
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Affiliation(s)
- Papan Thaipisuttikul
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Kriengsak Jaikla
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Sirikorn Satthong
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Pattarabhorn Wisajun
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
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Serum Vitamin D as a Biomarker in Autoimmune, Psychiatric and Neurodegenerative Diseases. Diagnostics (Basel) 2022; 12:diagnostics12010130. [PMID: 35054296 PMCID: PMC8774449 DOI: 10.3390/diagnostics12010130] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 02/05/2023] Open
Abstract
Vitamin D is a steroid hormone regulating calcium-phosphorus homeostasis, immune response and brain function. In the past thirty years, an increasing number of cohort studies, meta-analyses and randomized controlled trials (RTCs) evaluated the serum levels of 25-hydroxyvitamin D [25(OH)D], which is considered the Vitamin D status biomarker, in patients affected by neurological, psychiatric and autoimmune diseases. Although an association between low 25(OH)D serum levels and the prevalence of these diseases has been found, it is still unclear whether the serum 25(OH)D measurement can be clinically useful as a biomarker for diagnosis, prognosis and predicting treatment response in neurodegeneration, mental illness and immune-mediated disorders. The lack of standardized data, as well as discrepancies among the studies (in the analytical methods, cut-offs, endpoints and study sets), weakened the findings achieved, hindered pooling data, and, consequently, hampered drawing conclusions. This narrative review summarizes the main findings from the studies performed on serum 25(OH)D in neurological, psychiatric and autoimmune diseases, and clarifies whether or not serum 25(OH)D can be used as a reliable biomarker in these diseases.
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Geng T, Lu Q, Wan Z, Guo J, Liu L, Pan A, Liu G. Association of serum 25-hydroxyvitamin D concentrations with risk of dementia among individuals with type 2 diabetes: A cohort study in the UK Biobank. PLoS Med 2022; 19:e1003906. [PMID: 35025861 PMCID: PMC8797194 DOI: 10.1371/journal.pmed.1003906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 01/28/2022] [Accepted: 01/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Several epidemiological studies have suggested that vitamin D status is associated with risk of dementia in general populations. However, due to the synergistic effect between diabetic pathology and neuroinflammation, and the prothrombotic profile in patients with diabetes, whether vitamin D is associated with risk of dementia among patients with diabetes is unclear. This study aimed to investigate the associations of circulating vitamin D levels with risks of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD) among adults with type 2 diabetes (T2D). METHODS AND FINDINGS This study included 13,486 individuals (≥60 years) with T2D and free of dementia at recruitment (2006-2010) from the UK Biobank study. Serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured using the chemiluminescent immunoassay method at recruitment. Serum 25(OH)D ≥ 75 nmol/L was considered sufficient, according to the Endocrine Society Clinical Practice Guidelines. Incidence of all-cause dementia, AD, and VD cases was ascertained using electronic health records (EHRs). Each participant's person-years at risk were calculated from the date of recruitment to the date that dementia was reported, date of death, date of loss to follow-up, or 28 February 2018, whichever occurred first. Among the 13,486 individuals with T2D (mean age, 64.6 years; men, 64.3%), 38.3% had vitamin D ≥ 50 nmol/L and only 9.1% had vitamin D ≥ 75 nmol/L. During a mean follow-up of 8.5 years, we observed 283 cases of all-cause dementia, including 101 AD and 97 VD cases. Restricted cubic spline analysis demonstrated a nonlinear relationship between serum 25(OH)D and risk of all-cause dementia (Pnonlinearity < 0.001) and VD (Pnonlinearity = 0.007), and the nonlinear association reached borderline significance for AD (Pnonlinearity = 0.06), with a threshold at around a serum 25(OH)D value of 50 nmol/L for all the outcomes. Higher serum levels of 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD. The multivariate hazard ratios and 95% confidence intervals for participants who had serum 25(OH)D ≥ 50 nmol/L, compared with those who were severely deficient (25[OH]D < 25 nmol/L), were 0.41 (0.29-0.60) for all-cause dementia (Ptrend < 0.001), 0.50 (0.27-0.92) for AD (Ptrend = 0.06), and 0.41 (0.22-0.77) for VD (Ptrend = 0.01). The main limitation of the current analysis was the potential underreporting of dementia cases, as the cases were identified via EHRs. CONCLUSIONS In this study, we observed that higher concentrations of serum 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD among individuals with T2D. Our findings, if confirmed by replication, may have relevance for dementia prevention strategies that target improving or maintaining serum vitamin D concentrations among patients with T2D.
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Affiliation(s)
- Tingting Geng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingyu Guo
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
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Dominguez LJ, Veronese N, Vernuccio L, Catanese G, Inzerillo F, Salemi G, Barbagallo M. Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia. Nutrients 2021; 13:nu13114080. [PMID: 34836334 PMCID: PMC8624903 DOI: 10.3390/nu13114080] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023] Open
Abstract
Multiple factors combined are currently recognized as contributors to cognitive decline. The main independent risk factor for cognitive impairment and dementia is advanced age followed by other determinants such as genetic, socioeconomic, and environmental factors, including nutrition and physical activity. In the next decades, a rise in dementia cases is expected due largely to the aging of the world population. There are no hitherto effective pharmaceutical therapies to treat age-associated cognitive impairment and dementia, which underscores the crucial role of prevention. A relationship among diet, physical activity, and other lifestyle factors with cognitive function has been intensively studied with mounting evidence supporting the role of these determinants in the development of cognitive decline and dementia, which is a chief cause of disability globally. Several dietary patterns, foods, and nutrients have been investigated in this regard, with some encouraging and other disappointing results. This review presents the current evidence for the effects of dietary patterns, dietary components, some supplements, physical activity, sleep patterns, and social engagement on the prevention or delay of the onset of age-related cognitive decline and dementia.
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Affiliation(s)
- Ligia J. Dominguez
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
- Faculty of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy
- Correspondence: ; +39-0916554828
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Laura Vernuccio
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Giuseppina Catanese
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Flora Inzerillo
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Giuseppe Salemi
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, 90100 Palermo, Italy;
- UOC of Neurology, University Hospital “Paolo Giaccone”, 90100 Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
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Gáll Z, Székely O. Role of Vitamin D in Cognitive Dysfunction: New Molecular Concepts and Discrepancies between Animal and Human Findings. Nutrients 2021; 13:nu13113672. [PMID: 34835929 PMCID: PMC8620681 DOI: 10.3390/nu13113672] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE OF REVIEW increasing evidence suggests that besides the several metabolic, endocrine, and immune functions of 1alpha,25-dihydroxyvitamin D (1,25(OH)2D), the neuronal effects of 1,25(OH)2D should also be considered an essential contributor to the development of cognition in the early years and its maintenance in aging. The developmental disabilities induced by vitamin D deficiency (VDD) include neurological disorders (e.g., attention deficit hyperactivity disorder, autism spectrum disorder, schizophrenia) characterized by cognitive dysfunction. On the other hand, VDD has frequently been associated with dementia of aging and neurodegenerative diseases (e.g., Alzheimer's, Parkinson's disease). RECENT FINDINGS various cells (i.e., neurons, astrocytes, and microglia) within the central nervous system (CNS) express vitamin D receptors (VDR). Moreover, some of them are capable of synthesizing and catabolizing 1,25(OH)2D via 25-hydroxyvitamin D 1alpha-hydroxylase (CYP27B1) and 25-hydroxyvitamin D 24-hydroxylase (CYP24A1) enzymes, respectively. Both 1,25(OH)2D and 25-hydroxyvitamin D were determined from different areas of the brain and their uneven distribution suggests that vitamin D signaling might have a paracrine or autocrine nature in the CNS. Although both cholecalciferol and 25-hydroxyvitamin D pass the blood-brain barrier, the influence of supplementation has not yet demonstrated to have a direct impact on neuronal functions. So, this review summarizes the existing evidence for the action of vitamin D on cognitive function in animal models and humans and discusses the possible pitfalls of therapeutic clinical translation.
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Affiliation(s)
- Zsolt Gáll
- Department of Pharmacology and Clinical Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
- Correspondence:
| | - Orsolya Székely
- Department of Nephrology/Internal Medicine, Mures County Clinical Hospital, 540103 Târgu Mureș, Romania;
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Wang R, Wang W, Hu P, Zhang R, Dong X, Zhang D. Association of Dietary Vitamin D Intake, Serum 25(OH)D 3, 25(OH)D 2 with Cognitive Performance in the Elderly. Nutrients 2021; 13:nu13093089. [PMID: 34578965 PMCID: PMC8467888 DOI: 10.3390/nu13093089] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 12/23/2022] Open
Abstract
Background: As life expectancy increases, cognitive performance decline in the elderly has become one of the major global challenges. We aimed to evaluate the association of dietary vitamin D (VD), serum 25-hydroxyvitamin D3 (25(OH)D3), 25-hydroxyvitamin D2 (25(OH)D2), and total 25-hydroxyvitamin (25(OH)D) concentration with cognitive performance in older Americans. Methods: The data from the National Health and Nutrition Examination Survey (NHANES), 2011–2014 was used. The cognitive performance was assessed by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning sub-test, Animal Fluency test, and Digit Symbol Substitution Test (DSST). A binary logistic regression model was applied to evaluate the association between VD and cognitive performance, and restricted cubic spline model was adopted to evaluate the dose–response relationship. Results: While comparing to the lowest dietary VD intake group, the multivariate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of the highest dietary VD intake group were 0.51 (0.36–0.72) for the Animal Fluency test score and 0.45 (0.31–0.66) for DSST score, respectively; and those of serum total 25(OH)D and 25(OH)D3 concentration were 0.68 (0.47–0.97) and 0.62 (0.44–0.86) for DSST score. L-shaped relationships were identified for dietary VD intake, serum total 25(OH)D and 25(OH)D3 concentration with cognition performance. The associations between dietary VD intake, serum total 25(OH)D and cognitive performance were non-significant when stratified by gender. Conclusions: The study indicates that dietary VD intake, serum total 25(OH)D and 25(OH)D3 concentration were positively associated with cognitive performance. Further studies are needed to clarify the possible effects of dietary VD intake and serum 25(OH)D2, 25(OH)D3 on cognitive performance.
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Affiliation(s)
- RuTong Wang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (R.W.); (W.W.); (R.Z.); (X.D.)
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (R.W.); (W.W.); (R.Z.); (X.D.)
| | - Ping Hu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China;
| | - Ronghui Zhang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (R.W.); (W.W.); (R.Z.); (X.D.)
| | - Xue Dong
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (R.W.); (W.W.); (R.Z.); (X.D.)
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (R.W.); (W.W.); (R.Z.); (X.D.)
- Correspondence: ; Tel.: +86-5328-299-1712
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Lefèvre-Arbogast S, Dhana K, Aggarwal NT, Zhang S, Agarwal P, Liu X, Laranjo N, Carey V, Sacks F, Barnes LL, Arfanakis K. Vitamin D Intake and Brain Cortical Thickness in Community-Dwelling Overweight Older Adults: A Cross-Sectional Study. J Nutr 2021; 151:2760-2767. [PMID: 34113981 PMCID: PMC8417916 DOI: 10.1093/jn/nxab168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/02/2021] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Vitamin D is critical to brain health and a promising candidate to prevent cognitive decline and onset of Alzheimer disease (AD), although the underlying brain mechanisms are unclear. OBJECTIVES This study aimed to determine the association between vitamin D intake and brain cortical thickness in older adults. METHODS This was a cross-sectional investigation of 263 cognitively unimpaired participants, aged 65 y and older, participating in the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) trial (an ongoing study testing the effects of a 3-y diet intervention on cognitive decline). Vitamin D intake, from diet and supplements, was ascertained from an FFQ. Linear regression analysis, adjusted for age, sex, race, education, income, cognitive and physical activities, and cardiovascular disease risk factors, was used to determine the association between vitamin D intake and cortical thickness of the whole brain, lobes, and AD signature. RESULTS Total vitamin D intake was associated with cortical thickness of the temporal lobe and AD signature. Compared with individuals in the lowest quartile of total vitamin D intake [median: 140 international units (IU)/d], those in the highest quartile (median: 1439 IU/d) had a 0.038-mm (95% CI: 0.006, 0.069 mm) thicker temporal lobe and 0.041-mm (95% CI: 0.012, 0.070 mm) thicker AD signature. Most vitamin D intake was from supplements, and supplemental intake was also associated with cortical thickness. Compared with those who used no supplement, individuals taking 800-1000 IU/d and >1000 IU/d of supplemental vitamin D had a 0.039-mm (95% CI: 0.013, 0.066 mm) and 0.047-mm (95% CI: 0.013, 0.081 mm) thicker temporal lobe and a 0.037-mm (95% CI: 0.013, 0.061 mm) and 0.046-mm (95% CI: 0.015, 0.077 mm) thicker AD signature, respectively. Dietary vitamin D was not related to brain cortical thickness in our sample. CONCLUSIONS In cognitively unimpaired older adults, total and supplemental vitamin D intakes were associated with cortical thickness in regions vulnerable to AD.This trial was registered at clinicaltrials.gov as NCT02817074.
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Affiliation(s)
- Sophie Lefèvre-Arbogast
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Neelum T Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Shengwei Zhang
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Nancy Laranjo
- Department of Neurology, Rush University Medical Center, Chicago, IL, USA,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Vincent Carey
- Department of Neurology, Rush University Medical Center, Chicago, IL, USA,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Frank Sacks
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
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Anitha A, Viswambharan V, Thanseem I, Iype M, Parakkal R, Surendran SP, Mundalil MV. Vitamins and Cognition: A Nutrigenomics Perspective. CURRENT NUTRITION & FOOD SCIENCE 2021. [DOI: 10.2174/1573401316999200901180443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The rise in the prevalence of neurodegenerative and neurodevelopmental cognitive disorders
combined with a lack of efficient therapeutic strategies has necessitated the need to develop alternate
approaches. Dietary supplements are now being considered as a complementary and alternative
medicine for cognitive impairments. Considerable evidence suggests the role of vitamins in
modulating the genetic and epigenetic factors implicated in neuropsychiatric, neurodevelopmental
and neurodegenerative disorders. In this review, we provide an overview of the implications of nutrigenomics
with reference to vitamins that are suggested to boost cognitive functions (nootropic vitamins).
Several vitamins have been found to possess antioxidant and anti-inflammatory properties
which make them potential candidates in preventing or delaying age-related neurodegeneration and
cognitive decline. Well-designed longitudinal studies are essential to examine the association between
vitamins and cognitive functions. Future studies linking nutrition with advances in neuroscience,
genomics and epigenomics would provide novel approaches to managing cognitive disorders.
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Affiliation(s)
- Ayyappan Anitha
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Vijitha Viswambharan
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Ismail Thanseem
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Mary Iype
- Government Medical College, Thiruvananthapuram 695 011, Kerala, India
| | - Rahna Parakkal
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Sumitha P. Surendran
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
| | - Mahesh V. Mundalil
- Department of Neurogenetics, Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Palakkad 679 523, Kerala, India
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Zelzer S, Hofer E, Meinitzer A, Fritz-Petrin E, Simstich S, Goessler W, Schmidt R, Herrmann M. Association of vitamin D metabolites with cognitive function and brain atrophy in elderly individuals - the Austrian stroke prevention study. Aging (Albany NY) 2021; 13:9455-9467. [PMID: 33825696 PMCID: PMC8064143 DOI: 10.18632/aging.202930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/27/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vitamin D is a well-established regulator of calcium and phosphate metabolism that has neurotrophic and neuroprotective properties. Deficiency of vitamin D has been proposed to promote cognitive dysfunction and brain atrophy. However, existing studies provide inconsistent results. Here we aimed to investigate the association between vitamin D metabolites, cognitive function and brain atrophy in a cohort of well-characterized community-dwelling elderly individuals with normal neurological status and without history of stroke and dementia. METHODS 25(OH)D3, 25(OH)D2 and 24,25(OH)2D3 were measured by liquid-chromatography tandem mass-spectrometry in serum samples from 390 community-dwelling elderly individuals. All participants underwent thorough neuropsychiatric tests capturing memory, executive function and visuopractical skills. In 139 of these individuals, MRI of the brain was performed in order to capture neurodegenerative and vascular changes. RESULTS Total 25(OH)D (ß=0.003, 0.037), 24,25(OH)2D3 (ß=0.0456, p=0.010) and vitamin D metabolite ratio (VMR) (ß=0.0467, p=0.012) were significantly related to memory function. Adjustment for multiple testing weakened these relationships, but trends (p≤0.10) remained. 24,25(OH)2D3 and VMR showed similar trends also for visuopractical skills and global cognitive function. No significant relationships existed between vitamin D metabolites and MRI derived indices of neurodegeneration and vascular changes. Sub-group analyses of individuals with low concentrations of 25(OH)D and 24,25(OH)2D3 showed significantly worse memory function compared to individuals with normal or high concentrations. CONCLUSIONS Vitamin D deficient individuals appear to have a modest reduction of memory function without structural brain atrophy. Future studies should explore if vitamin D supplementation can improve cognitive function.
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Affiliation(s)
- Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | - Eva Fritz-Petrin
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | - Sebastian Simstich
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | | | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
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Bivona G, Lo Sasso B, Gambino CM, Giglio RV, Scazzone C, Agnello L, Ciaccio M. The Role of Vitamin D as a Biomarker in Alzheimer's Disease. Brain Sci 2021; 11:brainsci11030334. [PMID: 33800891 PMCID: PMC8000099 DOI: 10.3390/brainsci11030334] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 01/01/2023] Open
Abstract
Vitamin D and cognition is a popular association, which led to a remarkable body of literature data in the past 50 years. The brain can synthesize, catabolize, and receive Vitamin D, which has been proved to regulate many cellular processes in neurons and microglia. Vitamin D helps synaptic plasticity and neurotransmission in dopaminergic neural circuits and exerts anti-inflammatory and neuroprotective activities within the brain by reducing the synthesis of pro-inflammatory cytokines and the oxidative stress load. Further, Vitamin D action in the brain has been related to the clearance of amyloid plaques, which represent a feature of Alzheimer Disease (AD), by the immune cell. Based on these considerations, many studies have investigated the role of circulating Vitamin D levels in patients affected by a cognitive decline to assess Vitamin D’s eventual role as a biomarker or a risk factor in AD. An association between low Vitamin D levels and the onset and progression of AD has been reported, and some interventional studies to evaluate the role of Vitamin D in preventing AD onset have been performed. However, many pitfalls affected the studies available, including substantial discrepancies in the methods used and the lack of standardized data. Despite many studies, it remains unclear whether Vitamin D can have a role in cognitive decline and AD. This narrative review aims to answer two key questions: whether Vitamin D can be used as a reliable tool for diagnosing, predicting prognosis and response to treatment in AD patients, and whether it is a modifiable risk factor for preventing AD onset.
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Affiliation(s)
- Giulia Bivona
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Bruna Lo Sasso
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
- Department of Laboratory Medicine, AOUP “P. Giaccone”, 90127 Palermo, Italy
| | - Caterina Maria Gambino
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Rosaria Vincenza Giglio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Concetta Scazzone
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Luisa Agnello
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Marcello Ciaccio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
- Department of Laboratory Medicine, AOUP “P. Giaccone”, 90127 Palermo, Italy
- Correspondence:
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Sultan S. Neuroimaging changes associated with vitamin D Deficiency - a narrative review. Nutr Neurosci 2021; 25:1650-1658. [PMID: 33641639 DOI: 10.1080/1028415x.2021.1888206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ABSTRACTEmerging evidence suggests the role of vitamin D in brain health and its implication in the pathogenesis of cognitive impairment. The Aim of this review is to summarize current evidence on neuroimaging changes seen in vitamin D deficient individuals. Cross-sectional and longitudinal studies have consistently found an association between low serum 25 hydroxyvitamin D and cognitive impairment. Furthermore, investigating the association between serum 25 hydroxyvitamin D and neuroimaging abnormalities could provide an insight into the potential mechanisms underlying the association with cognitive impairment. Animal studies have demonstrated structural changes in the cerebral cortex and hippocampus of vitamin D deficient mice. Neuroimaging studies of the brain have shown increased white matter hyperintensities in periventricular, cortical, and juxtacortical areas and grey matter atrophy of the hippocampus, anterior cingulate cortex, and left calcarine sulcus in elderly with vitamin D deficiency.
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Affiliation(s)
- Sadia Sultan
- Department of Laboratory medicine, College of Applied Medical sciences, Umm Al-Qura University, Mecca, Saudi Arabia
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Vitamin D and Hospital Admission in Older Adults: A Prospective Association. Nutrients 2021; 13:nu13020616. [PMID: 33672800 PMCID: PMC7918803 DOI: 10.3390/nu13020616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 11/17/2022] Open
Abstract
The health effects of vitamin D are well documented, with increasing evidence of its roles beyond bone. There is, however, little evidence of the effects of vitamin D on hospitalisation among older adults. This study aimed to prospectively determine the relationship of vitamin D status in older adults with hospital admission and emergency department (ED) attendance. Trinity University of Ulster Department of Agriculture (TUDA) is a large cross-sectional study of older adults with a community population from three disease-defined cohorts (cognitive dysfunction, hypertension, and osteoporosis). Participants included in this analysis were recruited between 2008 and 2012. ED and hospital admission data were gathered from the date of TUDA participation until June 2013, with a mean follow up of 3.6 years. Of the 3093 participants, 1577 (50.9%) attended the ED during the period of follow-up. Attendees had lower mean serum 25(OH)D concentrations than non-attendees (59.1 vs. 70.6 nmol/L). Fully adjusted models showed an inverse association between vitamin D and ED attendance (Hazard Ratio (HR) 0.996; 95% Confidence Interval (CI) 0.995-0.998; p < 0.001). A total of 1269 participants (41%) were admitted to hospital during the follow-up. Those admitted had lower mean vitamin D concentrations (58.4 vs. 69.3 nmol/L, p < 0.001). In fully adjusted models, higher vitamin D was inversely associated with hospital admission (HR 0.996; 95% CI 0.994-0.998; p < 0.001) and length of stay (LOS) (β = -0.95, p = 0.006). This study showed independent prospective associations between vitamin D deficiency and increased hospitalisation by older adults. The need for further evaluation of current recommendations in relation to vitamin D supplementation, with consideration beyond bone health, is warranted and should focus on randomised controlled trials.
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Kłoszewska M, Łyszczarz B, Kędziora-Kornatowska K. Sociodemographic and Health-Related Factors Associated with Severity of Cognitive Impairment in Elderly Patients Hospital-ized in a Geriatric Clinic. Brain Sci 2021; 11:brainsci11020170. [PMID: 33572984 PMCID: PMC7911827 DOI: 10.3390/brainsci11020170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
Identification of risk factors for cognitive impairment is crucial for providing proper care and treatment. The aim of the study was to investigate the relationship between sociodemographic and health-related factors and the severity of cognitive impairment in elderly patients. In this retrospective study, we assessed the medical documentation of 323 patients aged 60+ years hospitalized in a geriatric clinic of university hospital. The patients were classified into five groups of cognitive impairment severity based on the Mini Mental State Examination and Clock Drawing Test. Kruskal-Wallis and Chi square tests and multivariate ordinal logistic regression were used to assess relationships involved. Cognitive impairment was identified in 84.2% of subjects. The following factors were indicative for higher level of cognitive disorders: primary and vocational education, older age, presence of vascular brain injury, and inability of walking independently. On the other hand, the factors associated with lower severity of cognitive impairment were co-morbid anxiety disorders, ischemic heart disease, and a higher BMI index. Dementia is one of the leading causes of disability and mortality in the elderly. Enhancing knowledge about the risk factors that worsen cognition is particularly relevant for accelerating the diagnosis of dementia and improving patient care.
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Affiliation(s)
- Marta Kłoszewska
- Department of Neurosurgery and Neurology, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, 85-168 Bydgoszcz, Poland;
| | - Błażej Łyszczarz
- Department of Health Economics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, 85-830 Bydgoszcz, Poland
- Correspondence: ; Tel.: +48 52585–54–08
| | - Kornelia Kędziora-Kornatowska
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland;
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Panza F, La Montagna M, Lampignano L, Zupo R, Bortone I, Castellana F, Sardone R, Borraccino L, Dibello V, Resta E, Altamura M, Daniele A, Lozupone M. Vitamin D in the development and progression of alzheimer's disease: implications for clinical management. Expert Rev Neurother 2021; 21:287-301. [PMID: 33406925 DOI: 10.1080/14737175.2021.1873768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Although the pathophysiological bases of Alzheimer's disease (AD) remain incompletely understood and disease-modifying therapies are not available, intervention on modifiable risk factors is warranted. Research on nutrition and dietary components is challenging and controversies still persist about the role of micro- and macronutrients and health outcomes in dementia. Importantly, results of preclinical investigations have shown that vitamin D triggers different neural pathways that may be protective against these neurodegenerative mechanisms, including the deposition of amyloid plaques, inflammatory processes, neurofibrillary degeneration, glutamatergic excitotoxicity, excessive intraneuronal calcium influx, and oxidative stress, although its relationship with AD still needs to be fully understood. AREAS COVERED The authors analyzed the recent evidence about the effects of vitamin D insufficiency on AD and the role of supplementation. EXPERT OPINION Both insufficient (25-49.9 ng/ml) and deficient levels (<25 ng/ml) of vitamin D may contribute to an increased susceptibility to AD. However, further well-designed prospective studies are needed for a better understanding of the involvement of low vitamin D concentrations in the AD natural history. Randomized clinical trials will also be necessary to address the issue of causality and determine whether vitamin D supplementation may be effective for the prevention or treatment of AD.
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Affiliation(s)
- Francesco Panza
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Maddalena La Montagna
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luisa Lampignano
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Roberta Zupo
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Ilaria Bortone
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Fabio Castellana
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Rodolfo Sardone
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Luisa Borraccino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vittorio Dibello
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy.,Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, The Netherlands
| | - Emanuela Resta
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari Aldo Moro, Bari, Italy.,Translational Medicine & Management of Health Systems, University of Foggia, Foggia, Italy
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy.,Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
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Fan YG, Pang ZQ, Wu TY, Zhang YH, Xuan WQ, Wang Z, Yu X, Li YC, Guo C, Wang ZY. Vitamin D deficiency exacerbates Alzheimer-like pathologies by reducing antioxidant capacity. Free Radic Biol Med 2020; 161:139-149. [PMID: 33068737 DOI: 10.1016/j.freeradbiomed.2020.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/05/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023]
Abstract
Vitamin D (VD) deficiency is prevalent among aging people and Alzheimer's disease (AD) patients. However, the roles of VD deficiency in the pathology of AD remain largely unexplored. In this study, APP/PS1 mice were fed a VD-deficient diet for 13 weeks to evaluate the effects of VD deficiency on the learning and memory functions and the neuropathological characteristics of the mice. Our study revealed that VD deficiency accelerated cognitive impairment in the APP/PS1 mice. Mechanistic studies revealed that VD deficiency promoted glial activation and increased inflammatory factor secretion. Furthermore, VD deficiency increased the production and deposition of Aβ by elevating the expression levels of amyloid precursor protein (APP) and β-site APP cleavage enzyme 1 (BACE1). In addition, VD deficiency increased the phosphorylation of Tau at Thr181, Thr205 and Ser396 by increasing the activities of cyclin-dependent kinase 5 (CDK5) and glycogen synthase kinase 3α/β (GSK3α/β) and promoted synaptic dystrophy and neuronal loss. All these effects of VD deficiency may be ascribed to enhanced oxidative stress via the downregulation of superoxide dismutase 1 (SOD1), glutathione peroxidase 4 (GPx4) and cystine/glutamate exchanger (xCT). Taken together, our data suggest that VD deficiency exacerbates Alzheimer-like pathologies via promoting inflammatory stress, increasing Aβ production and elevating Tau phosphorylation by decreasing antioxidant capacity in the brains of APP/PS1 mice. Hence, rescuing the VD status of AD patients should be taken into consideration during the treatment of AD.
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Affiliation(s)
- Yong-Gang Fan
- Institute of Health Sciences, Key Laboratory of Medical Cell Biology of Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Zhong-Qiu Pang
- College of Life and Health Sciences, Northeastern University, Shenyang, 110169, China
| | - Ting-Yao Wu
- First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Yan-Hui Zhang
- Institute of Health Sciences, Key Laboratory of Medical Cell Biology of Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Wen-Qiang Xuan
- College of Life and Health Sciences, Northeastern University, Shenyang, 110169, China
| | - Zhuo Wang
- Institute of Health Sciences, Key Laboratory of Medical Cell Biology of Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Xin Yu
- Institute of Health Sciences, Key Laboratory of Medical Cell Biology of Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Yan-Chun Li
- Department of Medicine, The University of Chicago, Chicago, IL, 60637, USA
| | - Chuang Guo
- College of Life and Health Sciences, Northeastern University, Shenyang, 110169, China.
| | - Zhan-You Wang
- Institute of Health Sciences, Key Laboratory of Medical Cell Biology of Ministry of Education, China Medical University, Shenyang, 110122, China.
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Okello EJ, Mendonça N, Stephan B, Muniz-Terrera G, Wesnes K, Siervo M. Tea consumption and measures of attention and psychomotor speed in the very old: the Newcastle 85+ longitudinal study. BMC Nutr 2020; 6:57. [PMID: 33042566 PMCID: PMC7537102 DOI: 10.1186/s40795-020-00361-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/14/2020] [Indexed: 12/27/2022] Open
Abstract
Background A number of studies have indicated a beneficial effect of tea consumption on the reduction of risk of cognitive impairment and dementia in older aged populations. However, there is a paucity of data on these associations in the very old, defined as individuals aged 85 years and over. We investigated the relationship between tea consumption in the very old and measures of global cognitive function, memory, attention and psychomotor speed. Method Longitudinal (5-years), population-based cohort study of individuals aged 85+ years in the North East of England, United Kingdom. Participants were community-dwelling and institutionalized men and women recruited through general medical practices (n = 676). Baseline tea consumption and longitudinal measures of global and domain specific (memory, speed and attention) cognitive function were assessed. Linear mixed models, controlling for demographic (e.g. age, sex and education) and health variables were used to determine whether tea consumption was protective against cognitive decline. Results Tea consumption was not associated with cognitive function at baseline on any measure (unadjusted and adjusted analyses). In the linear mixed effects models adjusted for age, sex, education and disease co-morbidity, higher tea consumption was associated with significantly better attention (focused and sustained attention), and psychomotor speed (complex tasks only) over five-years follow-up. However, there was no association between tea consumption and global cognitive function, memory or performance on simple speed tasks over time. Conclusions In this cohort study of non-demented very old adults we found that higher (vs. lower) tea consumption was associated with better performance over time on measures of focused and sustained attention and some psychomotor speed tasks. No associations with global cognition, memory or easy speed tasks (simple Reaction Time or Word Recognition) were detected. The results have implications for the development of possible diet-based interventions focused on improving cognitive function in the very old age group. These findings need to be confirmed in a sufficiently powered and well-designed RCT with non-demented very old adults.
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Affiliation(s)
- Edward Jonathan Okello
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU UK
| | - Nuno Mendonça
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS-UNL), Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
| | - Blossom Stephan
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Triumph Road, Nottingham, NG7 2TU UK
| | - Graciela Muniz-Terrera
- Centre for Dementia Prevention, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH16 4UX UK
| | - Keith Wesnes
- Wesnes Cognition Ltd, Streatley on Thames, RG8 9RD UK
| | - Mario Siervo
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Triumph Road, Nottingham, NG7 2TU UK
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Flanagan E, Lamport D, Brennan L, Burnet P, Calabrese V, Cunnane SC, de Wilde MC, Dye L, Farrimond JA, Emerson Lombardo N, Hartmann T, Hartung T, Kalliomäki M, Kuhnle GG, La Fata G, Sala-Vila A, Samieri C, Smith AD, Spencer JP, Thuret S, Tuohy K, Turroni S, Vanden Berghe W, Verkuijl M, Verzijden K, Yannakoulia M, Geurts L, Vauzour D. Nutrition and the ageing brain: Moving towards clinical applications. Ageing Res Rev 2020; 62:101079. [PMID: 32461136 DOI: 10.1016/j.arr.2020.101079] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/28/2020] [Accepted: 05/04/2020] [Indexed: 12/11/2022]
Abstract
The global increases in life expectancy and population have resulted in a growing ageing population and with it a growing number of people living with age-related neurodegenerative conditions and dementia, shifting focus towards methods of prevention, with lifestyle approaches such as nutrition representing a promising avenue for further development. This overview summarises the main themes discussed during the 3rd Symposium on "Nutrition for the Ageing Brain: Moving Towards Clinical Applications" held in Madrid in August 2018, enlarged with the current state of knowledge on how nutrition influences healthy ageing and gives recommendations regarding how the critical field of nutrition and neurodegeneration research should move forward into the future. Specific nutrients are discussed as well as the impact of multi-nutrient and whole diet approaches, showing particular promise to combatting the growing burden of age-related cognitive decline. The emergence of new avenues for exploring the role of diet in healthy ageing, such as the impact of the gut microbiome and development of new techniques (imaging measures of brain metabolism, metabolomics, biomarkers) are enabling researchers to approach finding answers to these questions. But the translation of these findings into clinical and public health contexts remains an obstacle due to significant shortcomings in nutrition research or pressure on the scientific community to communicate recommendations to the general public in a convincing and accessible way. Some promising programs exist but further investigation to improve our understanding of the mechanisms by which nutrition can improve brain health across the human lifespan is still required.
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Tobore TO. On the Etiopathogenesis and Pathophysiology of Alzheimer's Disease: A Comprehensive Theoretical Review. J Alzheimers Dis 2020; 68:417-437. [PMID: 30775973 DOI: 10.3233/jad-181052] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alzheimers' disease (AD) is the most common cause of dementia, with an estimated 5 million new cases occurring annually. Among the elderly, AD shortens life expectancy, results in disability, decreases quality of life, and ultimately, leads to institutionalization. Despite extensive research in the last few decades, its heterogeneous pathophysiology and etiopathogenesis have made it difficult to develop an effective treatment and prevention strategy. Aging is the biggest risk factor for AD and evidence suggest that the total number of older people in the population is going to increase astronomically in the next decades. Also, there is evidence that air pollution and increasing income inequality may result in higher incidence and prevalence of AD. This makes the need for a comprehensive understanding of the etiopathogenesis and pathophysiology of the disease extremely critical. In this paper, a quintuple framework of thyroid dysfunction, vitamin D deficiency, sex hormones, and mitochondria dysfunction and oxidative stress are used to provide a comprehensive description of AD etiopathogenesis and pathophysiology. The individual role of each factor, their synergistic and genetic interactions, as well as the limitations of the framework are discussed.
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Sato K, Mano T, Ihara R, Suzuki K, Tomita N, Arai H, Ishii K, Senda M, Ito K, Ikeuchi T, Kuwano R, Matsuda H, Iwatsubo T, Toda T, Iwata A. Lower Serum Calcium as a Potentially Associated Factor for Conversion of Mild Cognitive Impairment to Early Alzheimer's Disease in the Japanese Alzheimer's Disease Neuroimaging Initiative. J Alzheimers Dis 2020; 68:777-788. [PMID: 30814351 DOI: 10.3233/jad-181115] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Effect of serum calcium level to the incidence of mild cognitive impairment (MCI) conversion to early Alzheimer's disease (AD) remains uncertain. OBJECTIVE To investigate association between baseline serum calcium and the MCI conversion in the Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI) study cohort. METHODS In this sub-analysis of J-ADNI study, we reviewed data from MCI participants at baseline regarding their conversion to early AD during the 3 years of observation period and assessed the associated factors including serum calcium level. In addition, we compared our results from the J-ADNI study with the corresponding results from the North American (NA)-ADNI. RESULTS Of 234 eligible MCI participants from the J-ADNI cohort, 121 (51.7%) converted to AD during the first 36 months of observation. Using univariate analysis, being female, having shorter years of education, and lower serum calcium level were correlated with increased risk of MCI-to-AD conversion exclusively in J-ADNI cohort. The lower corrected serum calcium level remained as one of conversion-associated factors in the J-ADNI cohort even after adjustment for multiple confounding variables, although this was not observed in the NA-ADNI cohort. CONCLUSION Our findings suggest that lower serum calcium may be associated with an increased risk of MCI conversion to AD in Japanese cohorts. The reason for this correlation remains unclear and further external validation using other Asian cohorts is needed. It would be interesting for future AD studies to obtain serum calcium levels and other related factors, such as vitamin D levels, culture-specific dietary or medication information.
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Affiliation(s)
- Kenichiro Sato
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tatsuo Mano
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Ryoko Ihara
- Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo, Japan
| | - Kazushi Suzuki
- Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoki Tomita
- Department of Geriatrics and Gerontology, Division of Brain Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Hiroyuki Arai
- Department of Geriatrics and Gerontology, Division of Brain Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Kenji Ishii
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Michio Senda
- Institute of Biomedical Research and Innovation, Kobe, Japan
| | - Kengo Ito
- National Center for Geriatrics and Gerontology, Obu, Japan
| | | | | | - Hiroshi Matsuda
- National Center for Neurology and Psychiatry, Kodaira, Japan
| | - Takeshi Iwatsubo
- Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo, Japan.,Department of Neuropathology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tatsushi Toda
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Atsushi Iwata
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Moretti R, Caruso P, Storti B, Saro R, Kassabian B, Sala A, Giannini A, Gazzin S. Behavior in subcortical vascular dementia with sight pathologies: visual hallucinations as a consequence of precocious gait imbalance and institutionalization. Neurol Sci 2020; 41:3283-3292. [PMID: 32405881 DOI: 10.1007/s10072-020-04445-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/25/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Subcortical vascular dementia (sVAD) is considered the most frequent dementia in old population, and it is due to a small vessel disease. It has a very specific nosography, where the dominant factors are dysexecutive functions, depression, and apathy. Very few studies described visual hallucinations in sVAD, apart from in the final stages of it. METHODS This study recruited 577 patients with a diagnosis of sVAD associated with major ocular pathologies and 1118 patients with sVAD without any significant ocular pathology: Patients were followed up for 24 months. We studied the influence of ocular pathologies in precocious visual hallucinations, on behavior disorder (aggressiveness), and gait disorders (instability, fells). We registered the necessity of neuropsychiatric therapies, incidence of hospitalization, and institutionalization. RESULTS What emerges from our study is that the ocular comorbidities might change the behavior profile of dementia, provoking behavioral alterations, and the need for therapies with adverse effects. As far as old age is a complicated status of life, many factors can modify its development. The possible contribution of multiple biological events cannot be neglected, particularly the underlying influence of chronic diseases as well as the geriatric conditions, per se, might compromise the cognitive functions and the pathological conditions. Ocular pathology as a superimposing event in sVAD might worse the outcome. A correct and rapid identification of critical patients might be relevant for the dynamic life events in these patients and their caregivers.
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Affiliation(s)
- Rita Moretti
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume, 447, Trieste, Italy
| | - Paola Caruso
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume, 447, Trieste, Italy.
| | - Benedetta Storti
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume, 447, Trieste, Italy
| | - Riccardo Saro
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume, 447, Trieste, Italy
| | - Benedetta Kassabian
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume, 447, Trieste, Italy
| | - Alessia Sala
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume, 447, Trieste, Italy
| | - Anna Giannini
- Department of Medical Surgical and Health Sciences, Cattinara Hospital Trieste, University of Trieste, Strada di Fiume, 447, Trieste, Italy
| | - Silvia Gazzin
- Italian Liver Foundation, Science Park, Trieste, Italy
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Low Vitamin D and Its Association with Cognitive Impairment and Dementia. J Aging Res 2020; 2020:6097820. [PMID: 32399297 PMCID: PMC7210535 DOI: 10.1155/2020/6097820] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 03/03/2020] [Accepted: 03/26/2020] [Indexed: 12/11/2022] Open
Abstract
Vitamin D is a neurosteroid hormone that regulates neurotransmitters and neurotrophins. It has anti-inflammatory, antioxidant, and neuroprotective properties. It increases neurotrophic factors such as nerve growth factor which further promotes brain health. Moreover, it is also helpful in the prevention of amyloid accumulation and promotes amyloid clearance. Emerging evidence suggests its role in the reduction of Alzheimer's disease hallmarks such as amyloid-beta and phosphorylated tau. Many preclinical studies have supported the hypothesis that vitamin D leads to attentional, behavioral problems and cognitive impairment. Cross-sectional studies have consistently found that vitamin D levels are significantly low in individuals with Alzheimer's disease and cognitive impairment compared to healthy adults. Longitudinal studies and meta-analysis have also exhibited an association of low vitamin D with cognitive impairment and Alzheimer's disease. Despite such evidence, the causal association cannot be sufficiently answered. In contrast to observational studies, findings from interventional studies have produced mixed results on the role of vitamin D supplementation in the prevention and treatment of cognitive impairment and dementia. The biggest issue of the existing RCTs is their small sample size, lack of consensus over the dose, and age of initiation of vitamin D supplements to prevent cognitive impairment. Therefore, there is a need for large double-blind randomized control trials to assess the benefits of vitamin D supplementation in the prevention and treatment of cognitive impairment.
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Duchaine CS, Talbot D, Nafti M, Giguère Y, Dodin S, Tourigny A, Carmichael PH, Laurin D. Vitamin D status, cognitive decline and incident dementia: the Canadian Study of Health and Aging. Canadian Journal of Public Health 2020; 111:312-321. [PMID: 32016921 DOI: 10.17269/s41997-019-00290-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 12/19/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Vitamin D could prevent cognitive decline because of its neuroprotective, anti-inflammatory and antioxidant properties. This study aimed to evaluate the associations of plasma 25-hydroxyvitamin D (25(OH)D) concentrations with global cognitive function and incident dementia, including Alzheimer's disease (AD). METHODS The Canadian Study of Health and Aging is a 10-year cohort study of a representative sample of individuals aged 65 years or older. A total of 661 subjects initially without dementia with frozen blood samples and follow-up data were included. Global cognitive function was measured using the validated Modified Mini-Mental State (3MS) examination. A consensus diagnosis of all-cause dementia and AD was made between the physician and the neuropsychologist according to published criteria. Cognitive decline for a 5-year increase in age at specific 25(OH)D concentrations was obtained using linear mixed models with repeated measures. Hazard ratios of incident dementia and AD were obtained using semi-parametric proportional hazards models with age as time scale. RESULTS Over a mean follow-up of 5.4 years, 141 subjects developed dementia of which 100 were AD. Overall, no significant association was found between 25(OH)D and cognitive decline, dementia or AD. Higher 25(OH)D concentrations were associated with an increased risk of dementia and AD in women, but not in men. CONCLUSION This study does not support a protective effect of vitamin D status on cognitive function. Further research is needed to clarify the relation by sex.
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Affiliation(s)
- Caroline S Duchaine
- Centre d'excellence sur le vieillissement de Québec, 1050 Chemin Sainte-Foy, Local L2-32, Quebec, QC, G1S 4L8, Canada.,CHU de Québec-Université Laval Research Centre, Quebec, QC, Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada.,Institut sur le vieillissement et la participation sociale des aînés de l'Université Laval, Quebec, Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, CIUSSS-CN, Quebec, QC, Canada
| | - Denis Talbot
- Centre d'excellence sur le vieillissement de Québec, 1050 Chemin Sainte-Foy, Local L2-32, Quebec, QC, G1S 4L8, Canada.,CHU de Québec-Université Laval Research Centre, Quebec, QC, Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Mohamed Nafti
- Centre d'excellence sur le vieillissement de Québec, 1050 Chemin Sainte-Foy, Local L2-32, Quebec, QC, G1S 4L8, Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Yves Giguère
- CHU de Québec-Université Laval Research Centre, Quebec, QC, Canada.,Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Sylvie Dodin
- CHU de Québec-Université Laval Research Centre, Quebec, QC, Canada.,Faculty of Medicine, Laval University, Quebec, QC, Canada.,Institut sur la nutrition et les aliments fonctionnels, Laval University, Quebec, Canada
| | - André Tourigny
- Centre d'excellence sur le vieillissement de Québec, 1050 Chemin Sainte-Foy, Local L2-32, Quebec, QC, G1S 4L8, Canada.,CHU de Québec-Université Laval Research Centre, Quebec, QC, Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada.,Institut sur le vieillissement et la participation sociale des aînés de l'Université Laval, Quebec, Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, CIUSSS-CN, Quebec, QC, Canada
| | - Pierre-Hugues Carmichael
- Centre d'excellence sur le vieillissement de Québec, 1050 Chemin Sainte-Foy, Local L2-32, Quebec, QC, G1S 4L8, Canada.,CHU de Québec-Université Laval Research Centre, Quebec, QC, Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, CIUSSS-CN, Quebec, QC, Canada
| | - Danielle Laurin
- Centre d'excellence sur le vieillissement de Québec, 1050 Chemin Sainte-Foy, Local L2-32, Quebec, QC, G1S 4L8, Canada. .,CHU de Québec-Université Laval Research Centre, Quebec, QC, Canada. .,Institut sur le vieillissement et la participation sociale des aînés de l'Université Laval, Quebec, Canada. .,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, CIUSSS-CN, Quebec, QC, Canada. .,Institut sur la nutrition et les aliments fonctionnels, Laval University, Quebec, Canada. .,Faculty of Pharmacy, Laval University, Quebec, QC, Canada.
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Carnegie R, Zheng J, Sallis HM, Jones HJ, Wade KH, Evans J, Zammit S, Munafò MR, Martin RM. Mendelian randomisation for nutritional psychiatry. Lancet Psychiatry 2020; 7:208-216. [PMID: 31759900 PMCID: PMC6983323 DOI: 10.1016/s2215-0366(19)30293-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/05/2019] [Accepted: 07/12/2019] [Indexed: 12/14/2022]
Abstract
Nutritional psychiatry is a growing area of research, with several nutritional factors implicated in the cause of psychiatric ill-health. However, nutritional research is highly complex, with multiple potential factors involved, highly confounded exposures and small effect sizes for individual nutrients. This Personal View considers whether Mendelian randomisation provides a solution to these difficulties, by investigating causality in a low-risk and low-cost way. We reviewed studies using Mendelian randomisation in nutritional psychiatry, along with the potential opportunities and challenges of using this approach for investigating the causal effects of nutritional exposures. Several studies have identified nutritional exposures that are potentially causal by using Mendelian randomisation in psychiatry, offering opportunities for further mechanistic research, intervention development, and replication. The use of Mendelian randomisation as a foundation for intervention development facilitates the best use of resources in an emerging discipline in which opportunities are rich, but resources are often poor.
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Affiliation(s)
- Rebecca Carnegie
- Centre for Academic Mental Health, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Centre (MRC), Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
| | - Jie Zheng
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Centre (MRC), Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Hannah M Sallis
- Centre for Academic Mental Health, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Centre (MRC), Integrative Epidemiology Unit, University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK
| | - Hannah J Jones
- Centre for Academic Mental Health, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Centre (MRC), Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust, University of Bristol, Bristol, UK
| | - Kaitlin H Wade
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Centre (MRC), Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jonathan Evans
- Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - Stan Zammit
- Centre for Academic Mental Health, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust, University of Bristol, Bristol, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Marcus R Munafò
- Medical Research Centre (MRC), Integrative Epidemiology Unit, University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust, University of Bristol, Bristol, UK
| | - Richard M Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Centre (MRC), Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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Lee DH, Chon J, Kim Y, Seo YK, Park EJ, Won CW, Soh Y. Association between vitamin D deficiency and cognitive function in the elderly Korean population: A Korean frailty and aging cohort study. Medicine (Baltimore) 2020; 99:e19293. [PMID: 32080146 PMCID: PMC7034713 DOI: 10.1097/md.0000000000019293] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
It is well known that vitamin D (VitD) plays an important role in bone and calcium metabolism in the human body. VitD has additional roles in the body including modulation of cell growth, neurogenesis, neuroprotection, detoxification, immune function, and reduction of inflammation. Recent studies reveal insufficiency of VitD as a risk factor for cognitive decline or dementia. VitD has a role in normal brain function; insufficiency of VitD may lead to decreased memory and cognitive function.Using 2 years of baseline data from Korean frailty and aging cohort study, 2990 subjects (1415 men and 1575 women) were recruited. A short form of Korean version of the consortium to establish a registry for Alzheimer disease (CERAD-K), an assessment of cognitive status in patients with dementia was used. Among CERAD-K tests, we included word list memory/recall/recognition, digit span (forward, backward), trail making test (TMT) A, and mini-mental state examination in the Korean version of the CERAD assessment packet (MMSE-KC). Serum samples were collected and 25-hydroxyvitamin D (25(OH)D) was measured. Serum 25(OH)D concentrations were classified into clinically relevant categories as: deficient (<10 nmol/L), insufficient (10-30 nmol/L), and sufficient (≥30 nmol/L).The mean age of participants was 76.5 ± 3.9 years, and 52.7% were women. Among 2990 participants, 119 (4.0%) were classified as 25(OH)D deficient and 2253 (75.3%) as insufficient. Only 618 (20.7%) participants were sufficient for 25(OH)D. Among them performance in MMSE-KC, TMT A, and digit span tests was better in sufficient, insufficient, and deficient groups, which was statistically significant (P < .05). However, in multivariable regression analysis after adjusting for age, sex, body mass index, education, center, seasonality, physical activity, and alcohol use, association between 25(OH)D and cognitive function was not statistically significant.Although, when comparing VitD levels, there were differences in cognitive tests among the groups, fully adjusted analysis did not show any association. This result suggests that cognition was not affected by VitD levels alone but also population and sociological variables. In a fully adjusted model, there was no statistically significant association between VitD and cognitive function in the elderly Koreans in logistic regression analysis.
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Affiliation(s)
- Do Hun Lee
- Department of Physical Medicine & Rehabilitation Medicine, College of Medicine, Kyung Hee University Medical center
| | - Jinmann Chon
- Department of Physical Medicine & Rehabilitation Medicine, College of Medicine, Kyung Hee University Medical center
| | - Yong Kim
- Department of Physical Medicine & Rehabilitation Medicine, College of Medicine, Kyung Hee University Medical center
| | - Yun Kyung Seo
- Department of Physical Medicine & Rehabilitation Medicine, College of Medicine, Kyung Hee University Medical center
| | - Eo Jin Park
- Department of Physical Medicine & Rehabilitation, College of Medicine, Kyung Hee University Hospital at Gangdong
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Yunsoo Soh
- Department of Physical Medicine & Rehabilitation Medicine, College of Medicine, Kyung Hee University Medical center
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Abstract
Alzheimer's disease (AD) is the most common form of neurodegenerative dementia and there is no cure to date. Biomarkers in cerebrospinal fluid (CSF) are already included in the diagnostic work-up of symptomatic patients but markers for preclinical diagnosis and disease progression are not available. Furthermore, blood biomarkers are highly appreciated because they are minimally invasive and more accessible in primary care and in clinical studies. Mass spectrometry (MS) is an established tool for the measurement of various analytes in biological fluids such as blood. Its major strength is the high selectivity which is why it is also preferred as a reference method for immunoassays. MS has been used in several studies in the past for blood biomarker discovery and validation in AD using targeted MS such as multiple/selected reaction monitoring (MRM/SRM) or unbiased approaches (proteomics, metabolomics). In this short review, we give an overview on the status of current MS-based biomarker candidates for AD in blood plasma and serum.Plain Language Summary: Plain language summary available for this article.
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Affiliation(s)
- Patrick Oeckl
- Department of Neurology, Ulm University Hospital, Ulm, Germany.
| | - Markus Otto
- Department of Neurology, Ulm University Hospital, Ulm, Germany
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Chai B, Gao F, Wu R, Dong T, Gu C, Lin Q, Zhang Y. Vitamin D deficiency as a risk factor for dementia and Alzheimer's disease: an updated meta-analysis. BMC Neurol 2019; 19:284. [PMID: 31722673 PMCID: PMC6854782 DOI: 10.1186/s12883-019-1500-6] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 10/16/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We aimed to comprehensively explore the associations between serum 25(OH)D deficiency and risk of dementia and Alzheimer's disease(AD). METHODS We systematically searched Pubmed, the Cochrane Library, Embase and the reference lists of pertinent review articles for relevant articles published from database inception up until January 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with random effects models using the Stata 12.0 statistical software package. RESULTS Twelve prospective cohort studies and four cross-sectional studies were included in this meta-analysis. The pooled HRs of dementia and AD, respectively, were 1.32 (95%CI: 1.16, 1.52) and 1.34 (95%CI: 1.13, 1.60) for vitamin D deficiency (< 20 ng/ml). In the subgroup analyses, the pooled HRs of dementia and AD, respectively, were 1.48 (95%CI: 1.19, 1.85) and 1.51 (95%CI: 1.04, 2.18) for moderate vitamin D deficiency (10-20 ng/ml) and 1.20 (95%CI: 0.99, 1.44) and 1.36 (95%CI: 1.01, 1.84) for severe vitamin D deficiency (< 10 ng/ml). CONCLUSION There are significant associations between vitamin D deficiency and both dementia and AD. There are stronger associations between severe vitamin D deficiency (< 10 ng/ml) and both dementia and AD compared to moderate vitamin D deficiency (10-20 ng/ml).
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Affiliation(s)
- Bingyan Chai
- Department of Neurology,Gansu Provincial People’s Hospital, No.204, Donggang West Road, Lanzhou, 730000 Gansu China
- School of Clinical Medicine, Gansu university of Traditional Chinese medicine, No. 35 of Dingxi East Road, Lanzhou City, Gansu Province 730000 People’s Republic of China
| | - Fulin Gao
- Department of Neurology,Gansu Provincial People’s Hospital, No.204, Donggang West Road, Lanzhou, 730000 Gansu China
| | - Ruipeng Wu
- Department of Neurology,Gansu Provincial People’s Hospital, No.204, Donggang West Road, Lanzhou, 730000 Gansu China
| | - Tong Dong
- Department of Neurology,Gansu Provincial People’s Hospital, No.204, Donggang West Road, Lanzhou, 730000 Gansu China
| | - Cheng Gu
- Department of Neurology,Gansu Provincial People’s Hospital, No.204, Donggang West Road, Lanzhou, 730000 Gansu China
| | - Qiaoran Lin
- Department of Neurology,Gansu Provincial People’s Hospital, No.204, Donggang West Road, Lanzhou, 730000 Gansu China
| | - Yi Zhang
- Department of Neurology,Gansu Provincial People’s Hospital, No.204, Donggang West Road, Lanzhou, 730000 Gansu China
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Vitamin D as a Biomarker of Ill Health among the Over-50s: A Systematic Review of Cohort Studies. Nutrients 2019; 11:nu11102384. [PMID: 31590434 PMCID: PMC6836048 DOI: 10.3390/nu11102384] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background: The association between circulating levels of vitamin D and the incidence of chronic diseases is known. The identification of vitamin D as a biomarker of physiological/pathological ageing could contribute to expanding current knowledge of its involvement in healthy ageing. Methods: According to PRISMA guidelines, a systematic review was conducted on cohorts studying the role of 25OH-Vitamin D [25(OH)D] and 1,25(OH)2-Vitamin D [1,25(OH)2D] concentrations as biomarkers of healthy ageing. We consulted MedLine, Scopus, and Web of Science to search for studies on the association between vitamin D status in populations of originally healthy adults, and outcomes of longevity, illness, and physical and cognitive functionality. The quality of the studies was assessed using the Newcastle Ottawa scale. Results: Twenty cohorts from 24 articles were selected for this review. Inverse associations were found between low 25(OH)D levels and all-cause mortality, respiratory and cardiovascular events, as well as markers relating to hip and non-vertebral fractures. Associations between 1,25(OH)2D and healthy ageing outcomes gave similar results, although of lower clinical significance. Conclusions: This systematic review pinpoints peculiar aspects of vitamin D as a multidimensional predictor of ill health in the ageing process. Further well-designed controlled trials to investigate whether vitamin D supplement results in superior outcomes are warranted in the future.
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Bivona G, Lo Sasso B, Iacolino G, Gambino CM, Scazzone C, Agnello L, Ciaccio M. Standardized measurement of circulating vitamin D [25(OH)D] and its putative role as a serum biomarker in Alzheimer's disease and Parkinson's disease. Clin Chim Acta 2019; 497:82-87. [DOI: 10.1016/j.cca.2019.07.022] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 12/16/2022]
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Yang K, Chen J, Li X, Zhou Y. Vitamin D concentration and risk of Alzheimer disease: A meta-analysis of prospective cohort studies. Medicine (Baltimore) 2019; 98:e16804. [PMID: 31464906 PMCID: PMC6736453 DOI: 10.1097/md.0000000000016804] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Considerable controversy exists on the association between serum vitamin D concentrations and Alzheimer disease (AD) risk. This study aimed to synthesize the association of serum vitamin D concentrations with AD in adults. METHODS PubMed, Embase, and Cochrane library databases were searched for prospective cohort studies with data on serum vitamin D concentrations and AD risk. RESULT The studies that reported the adjusted relative risks (RRs) with 95% confidence intervals (CIs) of AD associated with serum vitamin D concentrations were included and subjected to subgroup analyses. Six prospective cohort studies with 1607 AD cases and 21,692 individuals were included in the meta-analysis. In 4 cohort studies with information about serum vitamin D concentrations <25 and 25 to 50 nmol/L, the random effects summary estimate did not show an increased risk of AD after adjustment for the established risk factors, while 3 cohort studies reported the RRs for incident AD per standard deviation (SD) decrease in serum vitamin D concentration and the random effects summary estimate did not show an increased risk of AD after adjustment for the established risk factors. CONCLUSIONS The current meta-analysis indicated that serum vitamin D deficiency (<25 nmol/L) or insufficiency (25-50 nmol/L) was not statistically significant and associated with the risk of AD.
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Affiliation(s)
- Kui Yang
- Neurology Department, The First Hospital of Lanzhou University, Lanzhou, Gansu
| | - Jun Chen
- Neurology Department, The First Hospital of Lanzhou University, Lanzhou, Gansu
| | - Xiaoguang Li
- Neurology Department, Peking Union Medical College Hospital, Beijing
| | - Yongning Zhou
- Gastroenterology Department, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
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Non-Skeletal Activities of Vitamin D: From Physiology to Brain Pathology. ACTA ACUST UNITED AC 2019; 55:medicina55070341. [PMID: 31284484 PMCID: PMC6680897 DOI: 10.3390/medicina55070341] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 12/17/2022]
Abstract
Vitamin D is a secosteroid hormone regulating the expression of almost 900 genes, and it is involved in the regulation of calcium and phosphate metabolism, immune response, and brain development. Low blood vitamin D levels have been reported in patients affected by various diseases. Despite a large amount of literature data, there is uncertainty surrounding the role of vitamin D as a serum biomarker in Alzheimer’s disease (AD) and Parkinson’s disease (PD). Indeed, the lack of internationally recognized 25(OH)D3 reference measurement procedures and standard materials in the past led to unstandardized serum total 25(OH)D3 results among research and clinical care laboratories. Thus, most of the literature studies reported unstandardized data, which are of little use and make it difficult to draw conclusions of the role of vitamin D in AD and PD. This review summarizes the extra-skeletal actions of vitamin D, focusing its role in immunomodulation and brain function, and reports the issue of lacking standardized literature data concerning the usefulness of vitamin D as a biomarker in AD and PD.
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Abstract
Objective: to summarise the activities that Vitamin D (VD) carries out in the brain and to clarify the potential role of VD in neurological diseases. Methods: a literature research has been performed in Pubmed using the following keywords: 'Vitamin D', 'nervous system', 'brain'. Results: the studies reviewed show that VD contributes to cerebral activity in both embryonic and adult brain, helping the connectivity of neural circuits responsible for locomotor, emotional and reward-dependent behavior. Low VD serum levels have been found in patients affected by Alzheimer Disease, Parkinson Disease, Multiple Sclerosis, Autism Spectrum Disorders, Sleep Disorders and Schizophrenia. Discussion: findings are controversial and should be interpreted with caution, since most of the studies performed have observational study set and few interventional studies are available, producing conflicting results. Overall, it can be stated that the potential role of Vitamin D in neurological diseases is mostly unclear and further randomised controlled trials are needed to understand better whether Vitamin D supplementation treatment can be useful in brain disorders.
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Affiliation(s)
- Giulia Bivona
- Section of Clinical Biochemistry and Clincal Molecular Medicine, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo , Palermo , Italy
| | - Caterina Maria Gambino
- Section of Clinical Biochemistry and Clincal Molecular Medicine, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo , Palermo , Italy
| | - Giorgia Iacolino
- Section of Clinical Biochemistry and Clincal Molecular Medicine, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo , Palermo , Italy
| | - Marcello Ciaccio
- Section of Clinical Biochemistry and Clincal Molecular Medicine, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo , Palermo , Italy.,Department and U.O.C. Laboratory Medicine, University Hospital "Paolo Giaccone" of Palermo , Palermo , Italy
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