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Dwimartutie N, Setiati S, Tamin TZ, Prijanti AR, Harahap AR, Purnamasari D, Harimurti K, Pramantara IDP, Suwarto S, Kojima T. Effect of cholecalciferol supplementation on hand grip strength, walking speed, and expression of vitamin D receptor, interleukin-6, and insulin-like growth factor-1 in monocyte in pre-frail older adults: A randomized double-blind placebo-controlled trial. Geriatr Gerontol Int 2024; 24:554-562. [PMID: 38644647 DOI: 10.1111/ggi.14881] [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: 10/23/2023] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
AIM To investigate the effect of cholecalciferol supplementation on hand grip strength, walking speed, and expression of vitamin D receptor (VDR), interleukine-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in monocyte in pre-frail older adults. METHODS We conducted a randomized double-blinded placebo-controlled clinical trial for 12 weeks, involving 120 pre-frail older adults who were randomized to the cholecalciferol group (cholecalciferol 4000 IU/day) or the placebo group. All subjects were given calcium lactate 500 mg/day. Hand grip strength and walking speed, as primary outcomes, were analyzed using intention-to-treat analysis. The expression of VDR, IGF-1 and IL-6 in monocytes, as secondary outcomes, were analyzed using per-protocol analysis. RESULTS After a 12-week intervention, there was a significant increase in serum 25(OH)D levels in both groups, with the increase being higher in the cholecalciferol group than in the placebo group (49.05 vs. 24.01 ng/mL; P < 0.001). No statistically significant differences were observed in hand grip strength (P = 0.228) and walking speed (P = 0.734) between the groups. There were no differences in the expression of VDR (P = 0.513), IL-6 (P = 0.509), and IGF-1 (P = 0.503) monocytes between the groups. CONCLUSIONS Cholecalciferol supplementation for 12 weeks increased serum 25(OH)D levels among pre-frail older adults. However, it did not improve hand grip strength and walking speed, and nor did it change the expression of VDR, IL-6, and IGF-1 in monocytes. Geriatr Gerontol Int 2024; 24: 554-562.
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Affiliation(s)
- Noto Dwimartutie
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Siti Setiati
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tirza Z Tamin
- Division of Musculoskeletal Rehabilitation, Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Ani Retno Prijanti
- Department of Biochemistry and Molecular Biology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Alida R Harahap
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dyah Purnamasari
- Division of Endocrine and Metabolic, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Kuntjoro Harimurti
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - I Dewa Putu Pramantara
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sardjito Hospital, Yogyakarta, Indonesia
| | - Suhendro Suwarto
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Llombart R, Mariscal G, Barrios C, de la Rubia Ortí JE, Llombart-Ais R. Does vitamin D deficiency affect functional outcomes in hip fracture patients? A meta-analysis of cohort studies. J Endocrinol Invest 2024; 47:1323-1334. [PMID: 38112912 DOI: 10.1007/s40618-023-02266-2] [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: 10/05/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Vitamin D deficiency is common in patients with hip fractures and may negatively affect functional recovery and quality of life (QOL). OBJECTIVE This study aimed to conduct a meta-analysis to quantify the effects of vitamin D deficiency on physical function and quality of life after hip fractures. METHODS The PubMed, EMBASE, Scopus, and Cochrane Library databases were searched for relevant studies. The inclusion criteria were hip fracture, comparison between vitamin D deficiency and normal vitamin D levels in patients with hip fracture, and functional outcome as the primary outcome. The exclusion criteria were case reports, reviews, duplicates, studies with a high risk of bias, and non-comparable or missing data. Two independent reviewers selected studies, extracted data, assessed bias, and performed meta-analyses using the Review Manager. Heterogeneity and publication bias were also assessed. Two independent reviewers selected the studies, extracted data, and assessed the risk of bias. We performed a meta-analysis using Review Manager and assessed heterogeneity and publication bias. RESULTS Seven studies with 1,972 patients were included. Vitamin D deficiency was defined as a 25(OH)D level < 20 ng/mL. There were no significant differences in the ability to walk (OR 0.68, 95% CI 0.31-1.53, I2 = 69%) or length of hospital stay (MD 2.27 days, 95% CI - 2.47 to 7.01, I2 = 93%) between patients with and without vitamin D deficiency. However, patients with vitamin D deficiency had significantly worse functional ability and quality of life (SMD - 1.50, 95% CI - 2.88 to - 0.12, I2 = 96%). CONCLUSIONS Despite the limitations of this study, such as small sample size, heterogeneous outcome assessments, and variable vitamin D measurement techniques, the results demonstrated that screening for vitamin D status and optimizing levels through supplementation could facilitate rehabilitation, promote lifestyle changes, aid in the recovery of independence, and help reduce long-term burdens.
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Affiliation(s)
- R Llombart
- Orthopedic Surgery Department, University Clinic of Navarra, Pamplona, Spain
| | - G Mariscal
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain.
| | - C Barrios
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain
| | - J E de la Rubia Ortí
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001, Valencia, Spain
| | - R Llombart-Ais
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain
- Traumacenter, Casa de Salud Hospital, Valencia, Spain
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Raczkiewicz D, Gujski M, Sarecka-Hujar B, Suski K, Pedrycz-Wieczorska A, Wdowiak A, Bojar I. Impact of Serum Vitamin D, B6, and B12 and Cognitive Functions on Quality of Life in Peri- and Postmenopausal Polish Women. Med Sci Monit 2024; 30:e943249. [PMID: 38769717 PMCID: PMC11127608 DOI: 10.12659/msm.943249] [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: 11/20/2023] [Accepted: 02/23/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Menopause initiates or accelerates health problems in a woman’s life, and affects cognitive processes and quality of life. We aimed to assess the quality of life, cognitive functions, and serum vitamin D, B6, and B12 concentrations in perimenopausal and postmenopausal Polish women. Also, we correlated the assessment of the quality of life with these vitamin concentrations and cognitive functions. MATERIAL AND METHODS The study was conducted in 287 perimenopausal and postmenopausal women. Serum levels of vitamin D, B6, and B12, cognitive functions using CNS Vital Signs software, and quality of life using WHO Quality of Life Brief were tested. RESULTS Almost all of the perimenopausal and postmenopausal women had normal concentrations of serum vitamin B12 (96%), 80% of them had normal B6 concentration, while only 9% had optimal serum vitamin D concentration. Postmenopausal women had lower Neurocognitive Index, psychomotor speed, motor speed, reaction time, and lower assessment of overall quality of life, physical health, and social relationships compared to perimenopausal women. In comparison to postmenopausal women, perimenopausal women had a lower serum vitamin B6 concentration, and the lower the concentration of this vitamin in serum they had, the lower they assessed their environment. Perimenopausal women assessed their social relationships the better, the better the visual memory, and the lower the processing speed they had. Postmenopausal women assessed the environment the better, the higher their Neurocognition Index was, and the better the reaction time they had. CONCLUSIONS Assessment of quality of life was associated with some cognitive functions in both perimenopausal and postmenopausal women.
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Affiliation(s)
- Dorota Raczkiewicz
- Department of Medical Statistics, School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Beata Sarecka-Hujar
- Department of Basic Biomedical Science, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Suski
- Department of Medical Statistics, School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland
| | | | - Artur Wdowiak
- Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University of Lublin, Poland
| | - Iwona Bojar
- Department of Women’s Health, Institute of Rural Health in Lublin, Lublin, Poland
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Maghbooli Z, Shirvani A, Moghadasi AN, Varzandi T, Hamtaei Ghashti S, Sahraian MA. Investigating the effects of 25-hydroxyvitamin D3 on clinical outcomes in multiple sclerosis patients: A randomized, double-blind clinical trial- a pilot study. Mult Scler Relat Disord 2024; 87:105673. [PMID: 38759424 DOI: 10.1016/j.msard.2024.105673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/03/2024] [Accepted: 05/05/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND The primary objective of this clinical trial was to assess whether administrating oral calcifediol (25(OH)D3) could enhance the clinical outcomes of patients diagnosed with multiple sclerosis. METHODS This clinical trial was designed as a randomized, double-blind, two-arm study, with 25 participants receiving daily 50 μg of calcifediol and 25 people receiving daily 50 μg of cholecalciferol. The primary outcomes were serum levels of 25(OH)D3, number of relapses, changes in Kurtzke Expanded Disability Status Scale (EDSS), the 25-foot walk, and cognitive function. RESULTS At the end of the trial, delta serum concentrations of 25(OH)D3 were 85.32±40.94 ng/ml in the calcifediol group compared to 13.72±11.56 ng/ml in the cholecalciferol group; 84 % of the calcifediol group and none of the cholecalciferol group had circulating 25(OH)D3 concentrations exceeding 70 ng/ml. While both groups showed an overall trend towards improved cognitive function at the end of the study, the calcifediol group exhibited greater improvements in most cognitive tests. However, the trial had no significant beneficial effects on MS relapse, EDSS score, quality of life, or fatigue in either group, the calcifediol or cholecalciferol. CONCLUSIONS The trial shows that calcifediol is more effective in rapidly increasing 25(OH)D3 levels in MS patients compared to cholecalciferol when administrated at a similar dosage.
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Affiliation(s)
- Zhila Maghbooli
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Shirvani
- Department of Medicine, Section of Endocrinology, Nutrition, Diabetes and Weight Management, Boston University Medical Center, Boston, Massachusetts, USA.
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tarlan Varzandi
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Hamtaei Ghashti
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neurosciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Bailey KRF, Pettersen JA. Vitamin D is associated with visual memory in young northern adolescents. Nutr Neurosci 2024; 27:392-403. [PMID: 37029691 DOI: 10.1080/1028415x.2023.2199498] [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: 04/09/2023]
Abstract
BACKGROUND Vitamin D status has been linked to visual memory in adults. We hypothesized a similar association in young adolescents. METHODS Participants were 9-13 years. The Rey-Osterrieth Complex Figure Task (ROCF), Rey Auditory Verbal Learning Task (RAVLT), Digit Span (Forward, Backward), and verbal fluency task assessed visual and verbal learning/memory, attention/working memory, and executive functioning/language, respectively. An at-home, mail-in blood spot test assessed 25(OH)D levels. RESULTS Participants (N = 56) were 10.7 ± 1.3 years, 61% females, 25(OH)D levels 84.2 ± 25 nmol/L(39.9 - 167.2 nmol/L) and 41% had insufficient vitamin D status (<75 nmol/L). Only measures of visual memory (ROCF-Recall, -%Recall of Copy) were significantly correlated with 25(OH)D, r = .34, p < .01 and r = .33, p < .01, respectively, and 25(OH)D remained a significant independent predictor on multiple regression analyses, which included age and sex.(ROCF-Recall overall model: Adj R2 = .24, p < .001; for 25(OH)D: p = .009; ROCF-%Recall of Copy overall model: Adj R2 = .20 p < .002; for 25(OH)D: p = .01). Individuals with sufficient vitamin D performed significantly better only on these measures (t-tests; ROCF-Recall, p = .016, d = 0.68; ROCF-%Recall of Copy, p = .022, d = 0.64). Despite moderate effect sizes (d = 0.4-0.5) in the Younger Age Group (9-10 years), only in the Older Age Group (11-13 years) was 25(OH)D significantly correlated with ROCF-Recall, r = .64, p = .0001 and ROCF-%Recall of Copy, r = .64, p = .0001, as well as working memory (Digit Span-Backward), Spearman's r = .46, p = .013. Similarly, those in the Older Age Group with sufficient vitamin D performed significantly better on ROCF-Recall, p = .01, d = 1.07; and ROCF-%Recall of Copy, p = .009, d = 1.08. CONCLUSIONS Vitamin D insufficiency was common in young adolescents. Similar to adults, visual memory was better among participants with higher 25(OH)D and those with sufficient levels. This effect was especially pronounced among older participants, suggesting possible time- and/or age-related implications of vitamin D status on cognition.
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Affiliation(s)
- Katherine R F Bailey
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Division of Medical Sciences, University of Northern British Columbia, Prince George, Canada
| | - Jacqueline A Pettersen
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Division of Medical Sciences, University of Northern British Columbia, Prince George, Canada
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Nguyen SA, Oughli HA, Lavretsky H. Use of Complementary and Integrative Medicine for Alzheimer's Disease and Cognitive Decline. J Alzheimers Dis 2024; 97:523-540. [PMID: 38073388 DOI: 10.3233/jad-230710] [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: 01/23/2024]
Abstract
Integrative medicine takes a holistic approach because it considers multiple aspects of the individual. This includes a person's physical, emotional, interpersonal, behavioral, nutritional, environmental, and spiritual dimensions of wellbeing that contribute to the Whole Person Health. There is increasing interest and popularity of integrative approaches to treating cognitive decline and dementia because of the multifactorial nature of aging and the limited pharmacological interventions available in treating cognitive decline and dementia, particularly Alzheimer's disease, the most common type of dementia. This review summarizes the existing evidence using complementary and integrative medicine therapies in cognitive decline and Alzheimer's disease. This includes the use of mind-body therapies, lifestyle interventions (nutritional, physical exercise, stress reduction), and other integrative modalities. Unfortunately, there are still limited studies available to guide clinicians despite the increasing popularity of integrative treatments.
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Affiliation(s)
- Sarah A Nguyen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Hanadi Ajam Oughli
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Zeqaj I, Piffero R, Calzaducca E, Pirisi M, Bellan M. The Potential Role of Vitamin D Supplementation in Cognitive Impairment Prevention. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:628-637. [PMID: 36998124 DOI: 10.2174/1871527322666230328130417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Vitamin D is implicated in many processes in the central nervous system (CNS), such as neurogenesis, neurotransmitter synthesis, synaptogenesis and protection against oxidative stress, thereby exerting a neuroprotective effect. OBJECTIVE In the present review, we aimed to evaluate the potential benefit(s) of vitamin D supplementation for CNS aging in different clinical contexts. METHODS We performed a literature search, looking for clinical trials and randomized clinical trials evaluating the effect of vitamin D supplementation on different endpoints related to cognitive outcomes. RESULTS Firstly, we identified 16 papers dealing with the impact of vitamin D supplementation on cognitive function in healthy subjects; the current literature suggests a real role for vitamin D supplementation in the prevention of cognitive decay in this clinical setting. Conversely, two papers suggest that vitamin D supplementation may be beneficial in patients with mild cognitive impairment (MCI). Finally, current data on vitamin D in Alzheimer's disease are contradictory. CONCLUSION Vitamin D supplementation may improve the cognitive outcomes of patients with MCI, whereas there is no evidence that it may prevent dementia or modulate the course of Alzheimer's disease.
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Affiliation(s)
- Iris Zeqaj
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Roberto Piffero
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Elisa Calzaducca
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Mario Pirisi
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
- CAAD, (Center for Translational Research on Autoimmune and Allergic Disease) Università del Piemonte Orientale UPO, Novara, Italy
| | - Mattia Bellan
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
- CAAD, (Center for Translational Research on Autoimmune and Allergic Disease) Università del Piemonte Orientale UPO, Novara, Italy
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Fekete M, Lehoczki A, Tarantini S, Fazekas-Pongor V, Csípő T, Csizmadia Z, Varga JT. Improving Cognitive Function with Nutritional Supplements in Aging: A Comprehensive Narrative Review of Clinical Studies Investigating the Effects of Vitamins, Minerals, Antioxidants, and Other Dietary Supplements. Nutrients 2023; 15:5116. [PMID: 38140375 PMCID: PMC10746024 DOI: 10.3390/nu15245116] [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: 11/13/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Cognitive impairment and dementia are burgeoning public health concerns, especially given the increasing longevity of the global population. These conditions not only affect the quality of life of individuals and their families, but also pose significant economic burdens on healthcare systems. In this context, our comprehensive narrative review critically examines the role of nutritional supplements in mitigating cognitive decline. Amidst growing interest in non-pharmacological interventions for cognitive enhancement, this review delves into the efficacy of vitamins, minerals, antioxidants, and other dietary supplements. Through a systematic evaluation of randomized controlled trials, observational studies, and meta-analysis, this review focuses on outcomes such as memory enhancement, attention improvement, executive function support, and neuroprotection. The findings suggest a complex interplay between nutritional supplementation and cognitive health, with some supplements showing promising results and others displaying limited or context-dependent effectiveness. The review highlights the importance of dosage, bioavailability, and individual differences in response to supplementation. Additionally, it addresses safety concerns and potential interactions with conventional treatments. By providing a clear overview of current scientific knowledge, this review aims to guide healthcare professionals and researchers in making informed decisions about the use of nutritional supplements for cognitive health.
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Affiliation(s)
- Mónika Fekete
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
| | - Andrea Lehoczki
- National Institute for Haematology and Infectious Diseases, Department of Haematology and Stem Cell Transplantation, South Pest Central Hospital, 1097 Budapest, Hungary;
| | - Stefano Tarantini
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Health Promotion Sciences, College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Peggy and Charles Stephenson Oklahoma Cancer Center, Oklahoma City, OK 73104, USA
| | - Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
| | - Tamás Csípő
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
| | - Zoltán Csizmadia
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
| | - János Tamás Varga
- Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
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Ling C, Sun L, Luo B, Yu H, Li W, Yang Y, Liu H. Association of bone turnover markers and cognitive function in Chinese chronic schizophrenia patients with or without vitamin D insufficiency. BMC Psychiatry 2023; 23:867. [PMID: 37993797 PMCID: PMC10664381 DOI: 10.1186/s12888-023-05375-7] [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: 07/18/2023] [Accepted: 11/11/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Increasing evidence shows that bone turnover markers (BTMs) and vitamin D can affect human cognitive function. However, there are few studies that have investigated the association between BTMs and cognitive function in chronic schizophrenia patients. The aim of this study was to investigate the relationship between BTMs and cognitive function in chronic schizophrenia patients with or without vitamin D insufficiency (VDI). METHODS In all, 118 chronic schizophrenia patients were enrolled in this cross-sectional study. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was applied to evaluate the cognitive function of the subjects. Blood analysis included bone turnover markers, vitamin D levels, and glycolipid levels. RESULTS Relative to 72 vitamin D-sufficient (VDS) patients, 46 VDI patients had higher bone resorption markers levels and lower bone formation markers levels. Regression analysis showed that, in the total sample, CTX and language function exhibited independent positive correlation (p = 0.027, R2 change = 0.042), and in the VDS group, procollagen type I N-terminal propeptide (PINP) was independently negatively correlated with language function (p = 0.031, R2 change = 0.065), while the positive correlation between osteopontin (OPN) and delayed memory remained in the VDI group (p = 0.036, R2 change = 0.083). CONCLUSION Our study showed an association between the levels of BTMs and cognitive function among chronic schizophrenia patients. This correlation may have different mechanisms of action at different vitamin D levels.
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Affiliation(s)
- Chen Ling
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, 230032, China
| | - Liling Sun
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Bei Luo
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, 230032, China
| | - Haiyun Yu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Wei Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Yating Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Huanzhong Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China.
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China.
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, 230032, China.
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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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11
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Role of Vitamin D Deficiency in the Pathogenesis of Cardiovascular and Cerebrovascular Diseases. Nutrients 2023; 15:nu15020334. [PMID: 36678205 PMCID: PMC9864832 DOI: 10.3390/nu15020334] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
Deficiency in vitamin D (VitD), a lipid-soluble vitamin and steroid hormone, affects approximately 24% to 40% of the population of the Western world. In addition to its well-documented effects on the musculoskeletal system, VitD also contributes importantly to the promotion and preservation of cardiovascular health via modulating the immune and inflammatory functions and regulating cell proliferation and migration, endothelial function, renin expression, and extracellular matrix homeostasis. This brief overview focuses on the cardiovascular and cerebrovascular effects of VitD and the cellular, molecular, and functional changes that occur in the circulatory system in VitD deficiency (VDD). It explores the links among VDD and adverse vascular remodeling, endothelial dysfunction, vascular inflammation, and increased risk for cardiovascular and cerebrovascular diseases. Improved understanding of the complex role of VDD in the pathogenesis of atherosclerotic cardiovascular diseases, stroke, and vascular cognitive impairment is crucial for all cardiologists, dietitians, and geriatricians, as VDD presents an easy target for intervention.
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12
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Giustina A, Bouillon R, Dawson-Hughes B, Ebeling PR, Lazaretti-Castro M, Lips P, Marcocci C, Bilezikian JP. Vitamin D in the older population: a consensus statement. Endocrine 2023; 79:31-44. [PMID: 36287374 PMCID: PMC9607753 DOI: 10.1007/s12020-022-03208-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/21/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND This paper reports results from the 5th International Conference "Controversies in Vitamin D" that was held in Stresa, Italy, 15-18 September 2021. The conference is part of this series that started in 2017 and has been conducted annually since. The objective of these conferences is to identify timely and controversial topics related to Vitamin D. Dissemination of the results of the conference through publications in peer-reviewed journals is an important means by which the most up to date information can be shared with physicians, investigators, and other health care professionals. Vitamin D and aging, the subject of this paper was featured at the conference. METHODS Participants were selected to review available literature on assigned topics related to vitamin D and aging and to present their findings with illustrative material, the intent of which was to stimulate discussion and to arrive at a consensus. The presentations were directed towards the following areas: impact of aging on vitamin D production and levels; skeletal effects of vitamin D deficiency in the older population; falls and vitamin D in the aging; potential extra skeletal effects of vitamin D; and strategies to prevent vitamin D deficiency. A final topic was related to how vitamin D might influence the efficacy of vaccines for Covid-19. RESULTS Hypovitaminosis D can lead to several skeletal and extra-skeletal outcomes. Older adults are at risk for vitamin D deficiency as both production and metabolism of vitamin D change with aging due to factors, such as reduced sun exposure and reduced production capacity of the skin. Skeletal consequences of these age-related changes can include reduced bone mineral density, osteomalacia and fractures. Potential extra-skeletal effects can include added risks for falls, reduced muscle strength, diabetes, cancer, and cardiovascular disease. Strategies to avoid these vitamin D deficiency-related negative outcomes include sun exposure, food fortification, and supplementation. While aging does not diminish sufficient reserve capacity for cutaneous vitamin D production, concerns about skin cancers and practical matters for the institutionalized elderly limit this option. Supplementation with vitamin D is the best option either pharmacologically or through food fortification. Regardless of treatment strategies, interventions to restore sufficient vitamin D status will show positive results only in those who are truly deficient. Thus, treatment goals should focus on avoiding 25(OH)D serum levels <30 nmol/l, with a goal to reach levels >50 nmol/l. CONCLUSIONS The results of this conference has led to consensus on several issues. Vitamin D supplementation should be combined with calcium to reduce fractures in the older population. The goal for adequate Vitamin D status should be to reach a serum level of 25(OH)D >50 nmol/l. It appears that daily low-dose vitamin D regimens reduce the risk of falling, especially in the elderly, compared with infrequent, large bolus doses that may increase it. The role of Vitamin D supplementation on muscle strength remains to be clarified. On the other hand, supplementation decreases the risk of progression to T2D from prediabetes among those who are Vitamin Ddeficient. Of three possible strategies to establish vitamin D sufficiency - sunshine exposure, food fortification, and supplementation - the latter seems to be the most effective and practical in the aging population.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan, Italy
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Aging, Leuven, KU, Belgium
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Marise Lazaretti-Castro
- Division of Endocrinology, Bone and Mineral Diseases Unit, Department of Internal Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section, Amsterdam University Medical Centre, Location VUMC, Amsterdam, The Netherlands
| | - Claudio Marcocci
- Department of Clinical and Internal Medicine, University of Pisa and Endocrine Unit 2, University Hospital of Pisa, Pisa, Italy
| | - John P Bilezikian
- Department of Medicine, Vagelos College of Physicians and Surgeons, New York City, NY, USA.
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13
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Chen M, Du Y, Tang W, Yu W, Li H, Zheng S, Cheng Q. Risk factors of mortality and second fracture after elderly hip fracture surgery in Shanghai, China. J Bone Miner Metab 2022; 40:951-959. [PMID: 35939235 DOI: 10.1007/s00774-022-01358-y] [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: 04/01/2022] [Accepted: 07/01/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Hip fracture is one of the leading causes of death and disability in the elderly. We analyzed the risk factors of mortality and second fracture within 2 years after hip fracture surgery in elderly Chinese patients. MATERIALS AND METHODS A total of 613 elderly patients after hip fracture surgery were selected, including 181 males and 432 females, and the patients were followed for at least 24 months. Information about patients and surgery was collected from medical records. Information on death, secondary fracture, and postoperative activities of daily living (ADL) was obtained by telephone follow-up. Cox regression was performed to identify risk factors associated with mortality and second fracture, measured by hazard ratio (HR). RESULTS The 1-year and 2-year mortality rates after hip fracture were 13.4% and 20.7%, respectively. The second fracture rate within 2 years was 9.5%. Male gender (HR 1.51, P = 0.035), increased age (HR 1.07, P < 0.001), preoperative hypoalbuminemia (HR 1.79, P = 0.004), preoperative pneumonia (HR 2.60, P = 0.005) and poor ADL (P = 0.048) were independent risk factors for 2-year mortality, while high preoperative hemoglobin (HR 0.98, P = 0.002), high preoperative eGFR (HR 0.99, P = 0.031), high preoperative LVEF (HR 0.92, P = 0.048) were protective factors for 2-year mortality. Poor ADL (P = 0.002) was the independent risk factor for second fracture within 2 years. CONCLUSIONS The 2-year mortality rate and second fracture rate after hip fracture in elderly remained high, which was related to old age and complications exists. Postoperative rehabilitation and improving ADL were very important to reduce mortality and second fracture.
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Affiliation(s)
- Minmin Chen
- Research Section of Geriatric Metabolic Bone Disease, Department of Osteoporosis and Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, 221 West Yan An Road, Shanghai, 200040, China
- Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Yanping Du
- Research Section of Geriatric Metabolic Bone Disease, Department of Osteoporosis and Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, 221 West Yan An Road, Shanghai, 200040, China
- Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Wenjing Tang
- Research Section of Geriatric Metabolic Bone Disease, Department of Osteoporosis and Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, 221 West Yan An Road, Shanghai, 200040, China
- Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Weijia Yu
- Research Section of Geriatric Metabolic Bone Disease, Department of Osteoporosis and Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, 221 West Yan An Road, Shanghai, 200040, China
- Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Huilin Li
- Research Section of Geriatric Metabolic Bone Disease, Department of Osteoporosis and Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, 221 West Yan An Road, Shanghai, 200040, China
- Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Songbai Zheng
- Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Qun Cheng
- Research Section of Geriatric Metabolic Bone Disease, Department of Osteoporosis and Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, 221 West Yan An Road, Shanghai, 200040, China.
- Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China.
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14
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Díaz G, Lengele L, Sourdet S, Soriano G, de Souto Barreto P. Nutrients and amyloid β status in the brain: A narrative review. Ageing Res Rev 2022; 81:101728. [PMID: 36049590 DOI: 10.1016/j.arr.2022.101728] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/18/2022] [Accepted: 08/26/2022] [Indexed: 01/31/2023]
Abstract
Amyloid beta (Aβ) is a peptide and a hallmark of Alzheimer's disease (AD). Emerging evidence suggests that Aβ levels could be influenced by diet. However, the evidence is sparse and for some nutrients, controversial. The aim of this narrative review is to gather the findings of observational and clinical trials involving human participants on the relationships between nutrients and brain Aβ status. Some dietary patterns are associated to reduced levels of Aβ in the brain, such as the Mediterranean diet, ketogenic diet as well as low intake of saturated fat, high-glycemic-index food, sodium, and junk/fast food. Low Aβ status in the brain was also associated with higher density lipoproteins (HDL) cholesterol and polyunsaturated fatty acids consumption. Data on alcohol intake is not conclusive. On the contrary, high Aβ levels in the brain were related to a higher intake of total cholesterol, triglycerides, low-density lipoproteins (LDL) cholesterol, saturated fat, sucrose, and fructose. Folic acid, cobalamin, vitamin E, and vitamin D were not associated to Aβ status, while high blood concentrations of Calcium, Aluminum, Zinc, Copper, and Manganese were associated with decreased Aβ blood levels but were not associated with Aβ cerebral spinal fluid (CSF) concentrations. In conclusion, certain dietary patterns and nutrients are associated to brain Aβ status. Further research on the association between nutrients and brain Aβ status is needed in order to pave the way to use nutritional interventions as efficacious strategies to prevent Aβ disturbance and potentially AD.
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Affiliation(s)
- Gustavo Díaz
- Faculty of Medicine, Research Institute on Nutrition, Genetics, and Metabolism, Universidad El Bosque, Bogotá, Colombia; Research In Colombia Foundation, Bogotá, Colombia.
| | - Laetitia Lengele
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo Universitaire de Toulouse, France
| | - Sandrine Sourdet
- Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Cedex 9, TSA 60033, Toulouse 31059, France
| | - Gaëlle Soriano
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo Universitaire de Toulouse, France; Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Cedex 9, TSA 60033, Toulouse 31059, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo Universitaire de Toulouse, France; UPS/Inserm, CERPOP UMR1295, University of Toulouse III, Toulouse, France
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15
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Kawahara T, Suzuki G, Mizuno S, Inazu T, Kasagi F, Kawahara C, Okada Y, Tanaka Y. Effect of active vitamin D treatment on development of type 2 diabetes: DPVD randomised controlled trial in Japanese population. BMJ 2022; 377:e066222. [PMID: 35613725 PMCID: PMC9131780 DOI: 10.1136/bmj-2021-066222] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess whether eldecalcitol, an active vitamin D analogue2, can reduce the development of type 2 diabetes among adults with impaired glucose tolerance. DESIGN Double blinded, multicentre, randomised, placebo controlled trial. SETTING Three hospitals in Japan, between June 2013 and August 2019. PARTICIPANTS People aged 30 years and older who had impaired glucose tolerance defined by using a 75 g oral glucose tolerance test and glycated haemoglobin level. INTERVENTIONS Participants were randomised to receive active vitamin D (eldecalcitol 0.75 μg per day; n=630) or matching placebo (n=626) for three years. MAIN OUTCOMES The primary endpoint was incidence of diabetes. Prespecified secondary endpoints were regression to normoglycaemia and incidence of type 2 diabetes after adjustment for confounding factors at baseline. In addition, bone densities and bone and glucose metabolism markers were assessed. RESULTS Of the 1256 participants, 571 (45.5%) were women and 742 (59.1%) had a family history of type 2 diabetes. The mean age of participants was 61.3 years. The mean serum 25-hydroxyvitamin D concentration at baseline was 20.9 ng/mL (52.2 nmol/L); 548 (43.6%) participants had concentrations below 20 ng/mL (50 nmol/L). During a median follow-up of 2.9 years, 79 (12.5%) of 630 participants in the eldecalcitol group and 89 (14.2%) of 626 in the placebo group developed type 2 diabetes (hazard ratio 0.87, 95% confidence interval 0.67 to 1.17; P=0.39). Regression to normoglycaemia was achieved in 145 (23.0%) of 630 participants in the eldecalcitol group and 126 (20.1%) of 626 in the placebo group (hazard ratio 1.15, 0.93 to 1.41; P=0.21). After adjustment for confounding factors by multivariable fractional polynomial Cox regression analysis, eldecalcitol significantly lowered the development of diabetes (hazard ratio 0.69, 0.51 to 0.95; P=0.020). In addition, eldecalcitol showed its beneficial effect among the participants with the lower level of basal insulin secretion (hazard ratio 0.41, 0.23 to 0.71; P=0.001). During follow-up, bone mineral densities of the lumbar spine and femoral neck and serum osteocalcin concentrations significantly increased with eldecalcitol compared with placebo (all P<0.001). No significant difference in serious adverse events was observed. CONCLUSIONS Although treatment with eldecalcitol did not significantly reduce the incidence of diabetes among people with pre-diabetes, the results suggested the potential for a beneficial effect of eldecalcitol on people with insufficient insulin secretion. TRIAL REGISTRATION UMIN Clinical Trials Registry UMIN000010758.
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Affiliation(s)
- Tetsuya Kawahara
- University of Occupational and Environmental Health, Kitakyushu, Japan
- Shin Komonji Hospital, Kitakyushu, Japan
| | - Gen Suzuki
- International University Health and Welfare Clinic, Ohtawara, Japan
| | | | | | | | - Chie Kawahara
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yosuke Okada
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- University of Occupational and Environmental Health, Kitakyushu, Japan
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16
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Gil Martínez V, Avedillo Salas A, Santander Ballestín S. Vitamin Supplementation and Dementia: A Systematic Review. Nutrients 2022; 14:1033. [PMID: 35268010 PMCID: PMC8912288 DOI: 10.3390/nu14051033] [Citation(s) in RCA: 28] [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: 02/04/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Dementia is a syndrome characterized by progressive cognitive impairment that interferes with independent function in daily activities. Symptoms of dementia depend on its cause and vary greatly between individuals. There is extensive evidence supporting a relationship between diet and cognitive functions. This systematic review studies the efficacy of using vitamin supplements in the diet as a solution to nutritional deficiencies and the prevention of dementia and mild cognitive impairment. METHODS An intensive search of different databases (PubMed, Web of Science, and Cochrane CENTRAL) was performed. Articles that were published between 2011 and November 2021 were retrieved using the mentioned search strategy. This systematic review has been conducted according to the PRISMA statement. RESULTS Folic acid supplementation proved to have better outcomes on cognitive tests than their respective control groups. The combined supplementation of folic acid and vitamin B12 showed some discrepancies between studies. Thiamine as supplementation did not only prove to have a positive impact on cognitive performance when given alone but also when given in combination with folic acid. Regarding vitamin D supplementation, the results observed were not so encouraging. A concomitant supplementation of low-dose vitamin E and vitamin C was also not associated with an improvement of cognitive function. CONCLUSIONS The findings of this systematic review suggest that supplementation of B Complex vitamins, especially folic acid, may have a positive effect on delaying and preventing the risk of cognitive decline. Ascorbic acid and a high dose of vitamin E, when given separately, also showed positive effects on cognitive performance, but there is not sufficient evidence to support their use. The results of vitamin D supplementation trials are not conclusive in assessing the potential benefits that vitamin D might have on cognition.
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Affiliation(s)
| | - Ana Avedillo Salas
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Sonia Santander Ballestín
- Department of Pharmacology, Physiology and Legal and Forensic Medicine, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain;
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17
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da Silva ABJ, Barros WMA, da Silva ML, Silva JML, Souza APDS, da Silva KG, de Sousa Fernandes MS, Carneiro ACBDF, Souza VDON, Lagranha CJ. Impact of vitamin D on cognitive functions in healthy individuals: A systematic review in randomized controlled clinical trials. Front Psychol 2022; 13:987203. [PMID: 36524160 PMCID: PMC9745323 DOI: 10.3389/fpsyg.2022.987203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/07/2022] [Indexed: 11/30/2022] Open
Abstract
Various functions in the central nervous system, such as growth, development, and cognition can be influenced by vitamins and minerals, which are capable of helping to maintain brain health and function throughout life. Cognition is understood as the aspects related to knowledge, learning, and understanding, as well as the ability to develop these functions. A possible association between low levels of vit D and deficit in the performance of cognitive functions in healthy humans or with some pathological condition is discussed. Because of this, the present systematic review analyzed only randomized clinical trials carried out in healthy non-athlete adults about intellectual and/or mental processes involving cognitive functions to identify whether these individuals with different levels of vit D are capable of interfering with the performance of the cognitive function. To do so, we adopted the PRISMA method criteria and registered it in the PROSPERO database. The search was performed in PubMed (MEDLINE), PsycINFO, Science Direct, Scopus, and Web of Science databases, 2,167 records were identified. The 5 most frequent cognitive domains in the selected studies were: processing speed, attention, verbal learning/memory, executive function, and general cognitive functions. We found that there are positive changes in the following domains: verbal memory and verbal working memory, learning memory, attention, executive function, and also cognitive function in general. We highlight the following suggestions for improvements that vitamin D supplementation may promote in the cognitive domains of healthy adults: a) low doses between 400 and 600 IU/d seem to be more effective when compared to doses between 2,400 and 5,000 IU/d and b) food fortification and enrichment with vit D, need further studies, as they seem to be more or as effective as synthetic supplementation. We evident that there is a need for trials that evaluate the control of vit D levels for healthy adult individuals is important, as they have the potential to minimize health problems, especially those involved in the reduction of cognitive abilities. Thus, the development of more clinical trials to obtain satisfactory answers on this topic needs to be encouraged. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021262413.
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Affiliation(s)
- Ana Beatriz Januário da Silva
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Waleska Maria Almeida Barros
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Mayara Luclécia da Silva
- Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil.,Programa de Pós-graduação Multicêntrico em Ciências Fisiológicas, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Brazil
| | - José Maurício Lucas Silva
- Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil.,Programa de Pós-graduação Multicêntrico em Ciências Fisiológicas, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Brazil
| | - Ana Patrícia da Silva Souza
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Karollainy Gomes da Silva
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Matheus Santos de Sousa Fernandes
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | | | | | - Cláudia Jacques Lagranha
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Laboratorio de Bioquimica Geral, Molecular e do Exercicio-Universidade Federal de Pernambuco, Centro Acadêmico de Vitória (CAV)-UFPE, Vitória de Santo Antão, PE, Brazil
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18
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Liu W, Zhou C, Wang Y, Yu H, Zhang X, Wang T, Wang L, Hao L, Qin Z, Xiao R. Vitamin D Deficiency Is Associated with Disrupted Cholesterol Homeostasis in Patients with Mild Cognitive Impairment. J Nutr 2021; 151:3865-3873. [PMID: 34510220 DOI: 10.1093/jn/nxab296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/08/2021] [Accepted: 08/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Several studies have reported that dietary and serum concentrations of vitamin D and cholesterol are correlated with mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about whether 25 hydroxyvitamin D [25(OH)D], lipids, and oxysterols are related to cognitive function. OBJECTIVE This study sought to explore the relations between 25(OH)D, lipids, oxysterols, and cognitive function. METHODS In this study, about 209 MCI patients and 209 age- and gender-matched healthy controls were recruited from the Shanxi province of China (49.5% male; median [IQR] age: 63 [59-66] y). Serum concentrations of 25(OH)D, lipids, and oxysterols were measured using ultra-performance LC-MS. Cognitive performance was determined via comprehensive mental, verbal, and auditory cognitive tests. Dietary information was collected using a semiquantitative FFQ and 3 consecutive days of 24-h dietary recalls. Logistic regression analyses, Spearman's correlation, and partial correlation analyses were used to explore correlation between the variables. RESULTS Participants with vitamin D deficiency [serum 25(OH)D <20.0 ng/mL] were 3 times more likely to develop MCI compared to those with adequate vitamin D (≥30 ng/mL) concentrations. The AUC of 25(OH)D was 0.72 and the cut-off was 16.5 ng/mL (sensitivity: 50.3%, specificity: 84.4%). Serum 25(OH)D concentrations were negatively correlated with total cholesterol (TC) (r = -0.19, P = 0.02), LDL-cholesterol (r = -0.17, P = 0.04), and 24S,25-epoxycholesterol (24S,25-epoxy-CHO) (r = -0.21, P = 0.01). Conversely, the Montreal Cognitive Assessment (MoCA) (r = 0.185, P < 0.001) and symbol digit modalities test (SDMT) (r = 0.11, P = 0.03) scores were positively correlated with serum 25(OH)D concentrations. CONCLUSION The study identified significant differences in serum 25(OH)D concentrations between MCI patients and cognitive healthy controls, and there was a correlation between serum concentrations of 25(OH)D, lipids, and oxysterols and cognitive impairment among people. This study was registered at the Chinese Clinical Trial Registry as ChiCTR1900025452.
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Affiliation(s)
- Wen Liu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | - Cui Zhou
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | - Yushan Wang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | - Huiyan Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | - Xiaona Zhang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | - Tao Wang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | - Lijing Wang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | - Ling Hao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
| | | | - Rong Xiao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China Capital Medical University, You An Men Wai, Beijing, China
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19
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Beauchet O, Cooper-Brown LA, Allali G. Vitamin D Supplementation and Cognition in Adults: A Systematic Review of Randomized Controlled Trials. CNS Drugs 2021; 35:1249-1264. [PMID: 34806158 DOI: 10.1007/s40263-021-00876-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The role of vitamin D supplementation in improving cognition and slowing the incidence of minor and major neurocognitive disorders is a matter of debate. To our knowledge, no systematic review of randomized controlled trials (RCTs) has examined this question in adults. OBJECTIVES The purpose of this systematic review is to synthesize the evidence regarding the effects of vitamin D supplementation on cognitive performance and neurocognitive disorders in adults. METHODS A systematic search of scientific articles in English or French was conducted. The MEDLINE (PubMed), EMBASE (Ovid, EMBASE), PsychINFO, and Cochrane Central databases were searched for records without any limit on publication date in May 2021. Inclusion criteria were (1) human participants, (2) RCT, (3) participant age ≥ 18, (4) vitamin D supplementation as the intervention, and (5) cognition (i.e., cognitive performance or cognitive status such as cognitively healthy or minor and major neurocognitive disorder) as the primary outcome. Two independent reviewers both assessed all eligible studies' full texts and the risk of bias arising from methodological issues using a standardized procedure. RESULTS Of the 2137 abstracts identified, 61 (2.9%) met screening inclusion criteria. After full text examination, 41 records (67.2%) were excluded. As a result, 20 RCTs (32.8%) were included in the systematic review. The review yielded mixed findings and, thus, failed to find evidence supporting cognitive benefits from vitamin D supplementation or suggesting a causal association between vitamin D and cognitive function. Half of the RCTs reported mixed results, one quarter negative results, and the last quarter positive effects for vitamin D supplementation on cognitive performance. The variability in serum 25-dihydroxyvitamin D concentration thresholds, the cognitive tests employed, the supplementation doses, and the samples' characteristics (i.e., ethnicity or number of participants) may explain these mixed findings. CONCLUSION This systematic review of RCTs does not support a role for vitamin D supplementation in enhancing cognition in adults.
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Affiliation(s)
- Olivier Beauchet
- Department of Medicine, University of Montreal, Montreal, QC, Canada. .,Research Center of the Geriatric University Institute of Montreal, Montreal, QC, Canada. .,Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada. .,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | - Liam A Cooper-Brown
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Gilles Allali
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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20
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Kang JH, Vyas CM, Okereke OI, Ogata S, Albert M, Lee IM, D'Agostino D, Buring JE, Cook NR, Grodstein F, Manson JE. Effect of vitamin D on cognitive decline: results from two ancillary studies of the VITAL randomized trial. Sci Rep 2021; 11:23253. [PMID: 34853363 PMCID: PMC8636504 DOI: 10.1038/s41598-021-02485-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/01/2021] [Indexed: 11/09/2022] Open
Abstract
Low vitamin D levels have been associated with cognitive decline; however, few randomized trials have been conducted. In a trial, we evaluated vitamin D3 supplementation on cognitive decline. We included participants aged 60+ years (mean[SD] = 70.9[5.8] years) free of cardiovascular disease and cancer in two substudies in the VITAL 2 × 2 randomized trial of vitamin D3 (2000 IU/day of cholecalciferol) and fish oil supplements: 3424 had cognitive assessments by phone (eight neuropsychologic tests; 2.8 years follow-up) and 794 had in-person assessments (nine tests; 2.0 years follow-up). The primary, pre-specified outcome was decline over two assessments in global composite score (average z-scores of all tests); substudy-specific results were meta-analyzed. The pooled mean difference in annual rate of decline (MD) for vitamin D3 versus placebo was 0.01 (95% CI - 0.01, 0.02; p = 0.39). We observed no interaction with baseline 25-hydroxyvitamin-D levels (p-interaction = 0.84) and a significant interaction with self-reported race (p-interaction = 0.01). Among Black participants (19%), those assigned vitamin D3 versus placebo had better cognitive maintenance (MD = 0.04, 95% CI 0.01, 0.08, similar to that observed for Black participants 1.2 years apart in age). Thus, vitamin D3 (2000 IU/day cholecalciferol) supplementation was not associated with cognitive decline over 2-3 years among community-dwelling older participants but may provide modest cognitive benefits in older Black adults, although these results need confirmation.Trial registration ClinicalTrials.gov; VITAL (NCT01169259), VITAL-DEP (NCT01696435) and VITAL-Cog (NCT01669915); the date the registration for the parent trial (NCT01169259) was submitted to the registry: 7/26/2010 and the date of first patient enrollment in either of the ancillary studies for cognitive function in a subset of eligible VITAL participants: 9/14/2011.
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Affiliation(s)
- Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA.
| | - Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Michelle Albert
- University of California at San Francisco School of Medicine, San Francisco, CA, USA
| | - I-Min Lee
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Denise D'Agostino
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Julie E Buring
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Nancy R Cook
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Francine Grodstein
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - JoAnn E Manson
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
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21
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Yang T, Wang H, Xiong Y, Chen C, Duan K, Jia J, Ma F. Vitamin D Supplementation Improves Cognitive Function Through Reducing Oxidative Stress Regulated by Telomere Length in Older Adults with Mild Cognitive Impairment: A 12-Month Randomized Controlled Trial. J Alzheimers Dis 2021; 78:1509-1518. [PMID: 33164936 DOI: 10.3233/jad-200926] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cognitive decline in older adults is a serious public health problem today. Association between vitamin D supplementation and cognition remains controversial. OBJECTIVE To determine whether a 12-month vitamin D supplementation improves cognitive function in elderly subjects with mild cognitive impairment (MCI), and whether it is mediated through the mechanism in which telomere length (TL) regulate oxidative stress. METHODS This was a double-blind, randomized, placebo-controlled trial in Tianjin, China. Participants were all native Chinese speakers aged 65 years and older with MCI. 183 subjects were randomized to an intervention group (vitamin D 800 IU/day, n = 93) or a placebo group (the matching starch granules, n = 90), and followed up for 12 months. Tests of cognitive function and mechanism-related biomarkers were evaluated at baseline, 6 months, and 12 months. RESULTS Repeated-measures ANOVA showed substantial improvements in the full scale intelligence quotient (FSIQ), information, digit span, vocabulary, block design, and picture arrangement scores in the vitamin D group over the placebo group (p < 0.001). Leukocyte TL was significantly higher, while serum 8-OXO-dG, OGG1mRNA, and P16INK4amRNA revealed greater decreases in the vitamin D group over the placebo group (p < 0.001). According to mixed-model repeated-measures ANOVA analysis, vitamin D group showed a significant enhancement in the FSIQ score for 12 months compared with the control (estimate value = 5.132, p < 0.001). CONCLUSION Vitamin D supplementation for 12 months appears to improve cognitive function through reducing oxidative stress regulated by increased TL in order adults with MCI. Vitamin D may be a promising public health strategy to prevent cognitive decline.
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Affiliation(s)
- Tong Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on environment, Nutrition and Public Health, Tianjin, China
| | - Hualou Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on environment, Nutrition and Public Health, Tianjin, China
| | - Ying Xiong
- Department of Community Service, Wangdingdi Hospital of Tianjin Nankai District, Tianjin, China
| | - Chong Chen
- Department of Clinical Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin, China.,National Human Genetic Resources Sharing Service Platform, Tianjin, China
| | - Keran Duan
- Biobank, Tianjin First Center Hospital, Tianjin, China
| | - Jingya Jia
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on environment, Nutrition and Public Health, Tianjin, China
| | - Fei Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on environment, Nutrition and Public Health, Tianjin, China
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22
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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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23
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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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24
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Hao L, Carson JL, Schlussel Y, Noveck H, Shapses SA. Vitamin D deficiency is associated with reduced mobility after hip fracture surgery: a prospective study. Am J Clin Nutr 2020; 112:613-618. [PMID: 32073599 PMCID: PMC7458775 DOI: 10.1093/ajcn/nqaa029] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/31/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hip fractures are associated with a high rate of morbidity and mortality, and successful ambulation after surgery is an important outcome in this patient population. OBJECTIVE This study aims to determine whether 25-hydroxyvitamin D [25(OH)D] concentration or the Geriatric Nutritional Risk Index (GNRI) is associated with mortality or rates of walking in a patient cohort after hip fracture surgery. METHODS Patients undergoing hip fracture repair from a multisite study in North America were included. Mortality and mobility were assessed at 30 and 60 d after surgery. Serum albumin, 25(OH)D, and intact parathyroid hormone were measured. Patients were characterized according to 25(OH)D <12 ng/mL, 12 to <20 ng/mL, 20 to <30 ng/mL, or ≥30 ng/mL. GNRI was categorized into major/moderate nutritional risk (<92), some risk (92 to <98), or in good nutritional status (≥98). RESULTS Of the 290 patients [aged 82 ± 7 y, BMI (kg/m2): 25 ± 5], 73% were women. Compared with patients with <12 ng/mL, those with higher 25(OH)D concentrations had higher rates of walking at 30 d (P = 0.031): 12 to <20 ng/mL (adjusted OR: 2.61; 95% CI: 1.13, 5.99); 20 to <30 ng/mL (3.48; 1.53, 7.95); ≥30 ng/mL (2.84; 1.12, 7.20). In addition, there was also greater mobility at 60 d (P = 0.028) in patients with higher 25(OH)D compared with the reference group (<12 ng/mL). Poor nutritional status (GNRI <92) showed an overall trend to reduce mobility (unadjusted P = 0.044 and adjusted P = 0.056) at 30 but not at 60 d. There was no association of vitamin D or GNRI with mortality at either time. CONCLUSIONS Vitamin D deficiency (<12 ng/mL) is associated with reduced ambulation after hip fracture surgery, whereas GNRI also contributes to immobility but is a less reliable predictor. Mechanisms that can explain why vitamin D deficiency is associated with mobility should be addressed in future studies.
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Affiliation(s)
- Lihong Hao
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ USA
- Rutgers Center for Lipid Research and the Center for NEx-Metabolism at the Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, USA
| | - Jeffrey L Carson
- Department of Medicine, Rutgers–Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Yvette Schlussel
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ USA
| | - Helaine Noveck
- Department of Medicine, Rutgers–Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Sue A Shapses
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ USA
- Rutgers Center for Lipid Research and the Center for NEx-Metabolism at the Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, USA
- Department of Medicine, Rutgers–Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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25
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Carvalho AC, Santos NC, Portugal-Nunes C, Castanho TC, Moreira P, Costa PS, Sousa N, Palha JA. 25-OH Vitamin D Levels and Cognitive Performance: Longitudinal Assessment in a Healthy Aging Cohort. Front Aging Neurosci 2019; 11:330. [PMID: 31827432 PMCID: PMC6890840 DOI: 10.3389/fnagi.2019.00330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 11/13/2019] [Indexed: 01/04/2023] Open
Abstract
Background: Declining serum levels of 25-hydroxyvitamin D [25(OH)D, a biomarker of vitamin D status] with aging is a well-recognized phenomenon. However, scarce information is available on the relation between 25(OH)D levels and cognitive performance over time in older individuals. Our purpose was to evaluate, longitudinally, the association of 25(OH)D with cognitive function in a healthy older adults’ cohort. Methods: Sixty-four individuals over 55 years-old with no cognitive impairment, clustered as healthy “Poor” and “Good” cognitive performers, were followed for an average of 18 months. Seasonal-adjusted 25(OH)D serum levels (measured by high-performance liquid chromatography-tandem mass spectrometry) were related, longitudinally, with cognitive (memory and general/executive) composite scores. Results: Overall seasonal-adjusted median serum 25(OH)D level was of 47 nmol/l [interquartile range (IQR), 38–60 nmol/l]. A negative correlation between baseline 25(OH)D and the general/executive composite score was found in the “Poor” cognitive performers (rs = −0.52, p = 0.006), an association lost after adjusting 25(OH)D levels for the season. No effect was found in both groups between seasonal-adjusted 25(OH)D levels and the variation of both memory and general/executive composites during follow-up when adjusted for age, gender and education level. Conclusion: In this healthy older population with no cognitive impairment, lower serum levels of 25(OH)D were not longitudinally associated with poorer cognitive scores.
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Affiliation(s)
- André Couto Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal.,Division of Endocrinology, Diabetes and Metabolism, Santo Antonio Hospital-Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal
| | - Teresa Costa Castanho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal
| | - Pedro Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal
| | - Patrício Soares Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal
| | - Joana Almeida Palha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.,Clinical Academic Center, Braga, Portugal
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