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Ma JH, Huang NH, Huang T, Mu DL. 25-hydroxyvitamin D concentrations and risk of incident dementia, mild cognitive impairment, and delirium in 443,427 UK Biobank participants. Psychiatry Res 2023; 327:115369. [PMID: 37523888 DOI: 10.1016/j.psychres.2023.115369] [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: 11/27/2022] [Revised: 05/20/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
This study aimed to investigate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and dementia, mild cognitive impairment (MCI), and delirium. Participants from the United Kingdom (UK) Biobank with complete information on serum 25(OH)D concentrations were enrolled. Dementia, MCI and delirium were defined using the UK Biobank algorithm. 443,427 participants with a mean (standard deviation) age of 56.8 (8.0) years were included in this study. Based on Cox regression models, serum 25(OH)D concentrations were inversely associated with the risk of dementia, MCI, and delirium in a dose-dependent manner after adjusting for demographics (P-trend <0.001). In comparison with 25(OH)D levels less than 32.4 nmol/L, participants with the highest 25(OH)D levels (i.e., >64.4 nmol/L) had the lowest risk of dementia (hazards ratio [HR]: 0.58, 95% confidence interval [CI] 0.49-0.69, P<0.001), MCI (HR: 0.55, 95% CI 0.37-0.84, P=0.005), and delirium (HR: 0.63, 95% CI 0.51-0.79, P<0.001). These results were consistent with the sensitivity analysis, in which participants with events occurring within the first two years of follow-up were excluded. This study found that a lower serum 25(OH)D concentration was significantly associated with a higher risk of dementia (including Alzheimer's disease and vascular dementia), MCI, and delirium.
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Affiliation(s)
- Jia-Hui Ma
- Department of Anesthesiology, Peking University First Hospital, Address: No. 8 Xishiku Street, Beijing 100034, PR China
| | - Ning-Hao Huang
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Address: No, 38 Xueyuanlu, Haidian district, Beijing 100191, PR China
| | - Tao Huang
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Address: No, 38 Xueyuanlu, Haidian district, Beijing 100191, PR China; State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing, PR China; Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, PR China.
| | - Dong-Liang Mu
- Department of Anesthesiology, Peking University First Hospital, Address: No. 8 Xishiku Street, Beijing 100034, PR China.
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Choudhary A, Kumar A, Sharma R, Khurana L, Jain S, Sharma S, Kumar D, Sharma S. Optimal vitamin D level ameliorates neurological outcome and quality of life after traumatic brain injury: a clinical perspective. Int J Neurosci 2023; 133:417-425. [PMID: 33930999 DOI: 10.1080/00207454.2021.1924706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Deficiency of vitamin D along with traumatic brain injury (TBI) augments the risk of injury severity. This possibly affects the therapeutic regimen prescribed for TBI which may pessimistically affects its outcome. METHODS Studies literature search was conducted in Google Scholar and PubMed. The inclusions were studies performed clinically on both male and female. All included studies' references were also reviewed to find any additional relevance related to this review. Studies published in English were considered for this review. This review focuses upon the incidence of vitamin D deficiency in TBI and how it affects the Quality of life of the sufferer. RESULTS A total of 176 studies were reviewed and 58 were thoroughly focussed for review as they met inclusion criteria. These studies demonstrate that levels of vitamin D influence the recovery outcome after TBI. Vitamin D deficiency has been found to cause more deterioration in severe TBI than in patients with mild TBI. CONCLUSION Paucity of vitamin D significantly affects the outcome after brain injury. This clearly validates the necessity for screening of vitamin D levels in neurological deficit in order to reduce the risk of morbidity in terms of neurocognitive disorder.
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Affiliation(s)
- Ajay Choudhary
- Department of Neurosurgery, PGIMER, Dr. R.M.L. Hospital, New Delhi, India
| | - Ashok Kumar
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
| | - Rajesh Sharma
- Department of Neurosurgery, PGIMER, Dr. R.M.L. Hospital, New Delhi, India
| | - Lipika Khurana
- Institute of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, New Delhi, India
| | - Smita Jain
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
| | - Shallu Sharma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
| | - Deepak Kumar
- Department of Physical Medicine and Rehabilitation, PGIMER, Dr. R.M.L. Hospital, New Delhi, India
| | - Swapnil Sharma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
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Low vitamin D status is associated with inflammatory response in older patients with cerebral small vessel disease. J Neuroimmunol 2023; 377:578057. [PMID: 36921477 DOI: 10.1016/j.jneuroim.2023.578057] [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: 12/15/2022] [Revised: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES This study aimed to determine the association of the NF-κB inflammatory signaling pathway with vitamin D status in older cerebral small vessel disease (SVD) patients. METHODS We measured serum 25(OH)D, pro-and anti-inflammatory cytokines, and mRNA levels of the vitamin D-activating enzyme, CYP27B1, as well as NF-kB, COX-2, the chemokine-CCL2, IL-1β, IL-6, TNF-α, TGF-β, and IL-10, in cerebral SVD patients aged ≥60 years presenting with vascular dementia and age and gender-matched healthy controls. RESULTS Low vitamin D status (insufficiency: serum 25(OH)D 12-20 ng/ml; deficiency: ≤12 ng/ml) was more prevalent among patients compared to controls. The mRNA levels of NF-kB, COX-2, CCL2, IL-1β, and IL-6, and serum levels of pro-inflammatory cytokines (IL-1α, IL-1β, IL-6, and TNF-α) were significantly higher in cases compared to controls. There was a significant correlation between CYP27B1 and NF-kB, COX-2, CCL2, and IL-1β gene expression. Serum IL-1α, IL-1β, and IL-6 concentrations and the expression of CCL-2, NF-kB2, and NF-kB3 genes were higher in vitamin D-deficient subjects compared to vitamin D-sufficient subjects. There was a significant negative correlation between serum 25(OH)D and IL-1α, IL-6, and TNF-α, and a positive correlation between 25(OH)D and IL-10. CONCLUSION Low vitamin D is associated with an inflammatory response via NF-kB signaling, which could play a role in the etio-pathogenesis of SVD. Further large-scale studies are required to validate our findings.
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Li Z, Li S, Xiao Y, Zhong T, Yu X, Wang L. Nutritional intervention for diabetes mellitus with Alzheimer's disease. Front Nutr 2022; 9:1046726. [DOI: 10.3389/fnut.2022.1046726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
The combined disease burden of diabetes mellitus (DM) and Alzheimer's disease (AD) is increasing, and the two diseases share some common pathological changes. However, the pharmacotherapeutic approach to this clinical complexity is limited to symptomatic rather than disease-arresting, with the possible exception of metformin. Whether nutritional intervention might extend or synergize with these effects of metformin is of interest. In particular, dietary patterns with an emphasis on dietary diversity shown to affect cognitive function are of growing interest in a range of food cultural settings. This paper presents the association between diabetes and AD. In addition, the cross-cultural nutritional intervention programs with the potential to mitigate both insulin resistance (IR) and hyperglycemia, together with cognitive impairment are also reviewed. Both dietary patterns and nutritional supplementation showed the effects of improving glycemic control and reducing cognitive decline in diabetes associated with AD, but the intervention specificity remained controversial. Multi-nutrient supplements combined with diverse diets may have preventive and therapeutic potential for DM combined with AD, at least as related to the B vitamin group and folate-dependent homocysteine (Hcy). The nutritional intervention has promise in the prevention and management of DM and AD comorbidities, and more clinical studies would be of nutritional scientific merit.
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Leirós M, Amenedo E, Rodríguez M, Pazo-Álvarez P, Franco L, Leis R, Martínez-Olmos MÁ, Arce C. Cognitive Status and Nutritional Markers in a Sample of Institutionalized Elderly People. Front Aging Neurosci 2022; 14:880405. [PMID: 35686024 PMCID: PMC9171327 DOI: 10.3389/fnagi.2022.880405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Since many of the risk factors for cognitive decline can be modified by diet, the study of nutrition and its relationships with cognitive status in aging has increased considerably in recent years. However, there are hardly any studies that have assessed cognitive status using a comprehensive set of neuropsychological tests along with measures of functional capacity and mood and that have related it to nutritional status measured from several nutritional parameters that have shown its relationships with cognitive function. Objective To test the differences in depressive symptomatology and in several measures of nutritional status between three groups classified according to their cognitive status (CS hereafter). Method One hundred thirteen participants from nursing homes in Galicia, Spain, underwent a comprehensive neuropsychological examination, including a general screening test (MMSE) and tests for different cognitive domains along with measures of activities of daily living (ADL) and assessment of depressive symptomatology (GDS-SF). According to established clinical criteria, participants were divided into three CS groups, Cognitively Intact (CI), Mild Cognitive Impairment (MCI), and All-Cause Dementia (ACD). Nutritional status was also examined using blood-derived measures, body mass index (BMI) and a nutritional screening test (MNA-SF). Differences between CS groups in all nutritional variables were studied by one-way ANOVAs with post-hoc Bonferroni correction or Kruskal-Wallis with Games-Howell post-hoc correction when appropriate. Multinomial logistic regression was also applied to test the association between nutritional variables and CS. Results Differences between CS groups were statistically significant for depressive symptomatology, vitamin A and D, albumin, selenium (Se), uric acid (UA), and BMI. The results of multinomial logistic regression found positive associations between groups with better CS and higher concentrations of vitamins A and D, transthyretin (TTR), albumin, Se, and UA, while negative associations were found for BMI. Conclusion Higher serum levels of vitamin A, vitamin D, TTR, albumin, Se, and UA could act as protective factors against cognitive decline, whereas higher BMI could act as a risk factor.
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Affiliation(s)
- María Leirós
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Elena Amenedo
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Marina Rodríguez
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Paula Pazo-Álvarez
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Luis Franco
- Economic Analysis and Modeling Group, Instituto de Estudios y Desarrollo de Galicia (IDEGA), Santiago de Compostela, Spain
| | - Rosaura Leis
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Clínico Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Department of Forensic Sciences, Pathological Anatomy, Gynecology and Obstetrics, and Pediatrics, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Miguel-Ángel Martínez-Olmos
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), Madrid, Spain.,Section of Endocrinology-Nutrition Area, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Constantino Arce
- Department of Social, Basic and Methodology Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Uthaiah CA, Beeraka NM, Rajalakshmi R, Ramya CM, Madhunapantula SV. Role of Neural Stem Cells and Vitamin D Receptor (VDR)-Mediated Cellular Signaling in the Mitigation of Neurological Diseases. Mol Neurobiol 2022; 59:4065-4105. [PMID: 35476289 DOI: 10.1007/s12035-022-02837-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/09/2022] [Indexed: 12/19/2022]
Abstract
Specific stem cell-based therapies for treating Alzheimer's disease, Parkinson's disease, and schizophrenia are gaining importance in recent years. Accumulating data is providing further support by demonstrating the efficacy of neural stem cells in enhancing the neurogenesis in the aging brain. In addition to stem cells, recent studies have shown the efficacy of supplementing vitamin D in promoting neurogenesis and neuronal survival. Studies have also demonstrated the presence of mutational variants and single-nucleotide polymorphisms of the vitamin D receptor (VDR) in neurological disorders; however, implications of these mutations in the pathophysiology and response to drug treatment are yet to be explored. Hence, in this article, we have reviewed recent reports pertaining to the role of neural stem cells and VDR-mediated cellular signaling cascades that are involved in enhancing the neurogenesis through Wnt/β-catenin and Sonic Hedgehog pathways. This review benefits neurobiologists and pharmaceutical industry experts to develop stem cell-based and vitamin D-based therapies to better treat the patients suffering from neurological diseases.
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Affiliation(s)
- Chinnappa A Uthaiah
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR, DST-FIST Supported Center), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, 570015, Karnataka, India
| | - Narasimha M Beeraka
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR, DST-FIST Supported Center), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, 570015, Karnataka, India
| | - R Rajalakshmi
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, 570015, Karnataka, India
| | - C M Ramya
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, 570015, Karnataka, India
| | - SubbaRao V Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR, DST-FIST Supported Center), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, 570015, Karnataka, India.
- Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Academy of Higher Education & Research (JSS AHER), Mysuru, 570015, Karnataka, India.
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7
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Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports? Healthcare (Basel) 2022; 10:healthcare10020186. [PMID: 35206801 PMCID: PMC8872051 DOI: 10.3390/healthcare10020186] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 12/13/2022] Open
Abstract
Factors influencing brain function and cognitive performance can be critical to athletic performance of esports athletes. This review aims to discuss the potential beneficial effects of micronutrients, i.e., vitamins, minerals and biologically active substances on cognitive functions of e-athletes. Minerals (iodine, zinc, iron, magnesium) and vitamins (B vitamins, vitamins E, D, and C) are significant factors that positively influence cognitive functions. Prevention of deficiencies of the listed ingredients and regular examinations can support cognitive processes. The beneficial effects of caffeine, creatine, and probiotics have been documented so far. There are many plant products, herbal extracts, or phytonutrients that have been shown to affect precognitive activity, but more research is needed. Beetroot juice and nootropics can also be essential nutrients for cognitive performance. For the sake of players’ eyesight, it would be useful to use lutein, which, in addition to improving vision and protecting against eye diseases, can also affect cognitive functions. In supporting the physical and mental abilities of e-athletes the base is a well-balanced diet with adequate hydration. There is a lack of sufficient evidence that has investigated the relationship between dietary effects and improved performance in esports. Therefore, there is a need for randomized controlled trials involving esports players.
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Broberg D, Wong D, Bellyou M, Montero-Odasso M, Beauchet O, Annweiler C, Bartha R. Effects of Memantine and High Dose Vitamin D on Gait in Male APP/PS1 Alzheimer's Disease Mice Following Vitamin D Deprivation. J Alzheimers Dis 2021; 85:1755-1766. [PMID: 34958027 DOI: 10.3233/jad-215188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Altered gait is a frequent feature of Alzheimer's disease (AD), as is vitamin D deficiency. Treatment with memantine and vitamin D can protect cortical axons from exposure to amyloid-β and glutamate toxicity, suggesting this combination may mitigate altered gait in AD. OBJECTIVE Investigate the effects of vitamin D deprivation and subsequent treatment with memantine and vitamin D enrichment on gait performance in APPswe/PS1dE9 mice. METHODS Male APPswe/PS1dE9 mice were split into four groups (n = 14 each) at 2.5 months of age. A control group was fed a standard diet throughout while the other three groups started a vitamin D-deficient diet at month 6. One group remained on this deficient diet for the rest of the study. At month 9, the other two groups began treatment with either memantine alone or memantine combined with 10 IU/g of vitamin D. Gait was assessed using CatWalk at months 6, 9, 12, and 15. RESULTS Vitamin D deprivation led to a 13% increase in hind stride width by month 15 (p < 0.001). Examination of the treatment groups at month 15 revealed that mice treated with memantine alone still showed an increase in hind stride width compared to controls (p < 0.01), while mice treated with memantine and vitamin D did not (p = 0.21). CONCLUSION Vitamin D deprivation led to impaired postural control in the APPswe/PS1dE9 model. Treatment with memantine and vitamin D, but not memantine alone, prevented this impairment. Future work should explore the potential for treatments incorporating vitamin D supplementation to improve gait in people with AD.
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Affiliation(s)
- Dana Broberg
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
| | - Dickson Wong
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
| | - Miranda Bellyou
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, ON, Canada
| | - Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, University of Western Ontario, London, ON, Canada.,Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Olivier Beauchet
- Department of Medicine, University of Montreal, Montreal, QC, Canada.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Cedric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.,UNIV ANGERS, UPRES EA 4638, University of Angers, Angers, France.,Gérontopôle Autonomie Longévité des Pays de la Loire, France
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
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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: 52] [Impact Index Per Article: 17.3] [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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Wong D, Broberg DN, Doad J, Umoh JU, Bellyou M, Norley CJD, Holdsworth DW, Montero-Odasso M, Beauchet O, Annweiler C, Bartha R. Effect of Memantine Treatment and Combination with Vitamin D Supplementation on Body Composition in the APP/PS1 Mouse Model of Alzheimer's Disease Following Chronic Vitamin D Deficiency. J Alzheimers Dis 2021; 81:375-388. [PMID: 33780366 DOI: 10.3233/jad-201137] [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] [Indexed: 12/16/2022]
Abstract
BACKGROUND Vitamin D deficiency and altered body composition are common in Alzheimer's disease (AD). Memantine with vitamin D supplementation can protect cortical axons against amyloid-β exposure and glutamate toxicity. OBJECTIVE To study the effects of vitamin D deprivation and subsequent treatment with memantine and vitamin D enrichment on whole-body composition using a mouse model of AD. METHODS Male APPswe/PS1dE9 mice were divided into four groups at 2.5 months of age: the control group (n = 14) was fed a standard diet throughout; the remaining mice were started on a vitamin D-deficient diet at month 6. The vitamin D-deficient group (n = 14) remained on the vitamin D-deficient diet for the rest of the study. Of the remaining two groups, one had memantine (n = 14), while the other had both memantine and 10 IU/g vitamin D (n = 14), added to their diet at month 9. Serum 25(OH)D levels measured at months 6, 9, 12, and 15 confirmed vitamin D levels were lower in mice on vitamin D-deficient diets and higher in the vitamin D-supplemented mice. Micro-computed tomography was performed at month 15 to determine whole-body composition. RESULTS In mice deprived of vitamin D, memantine increased bone mineral content (8.7% increase, p < 0.01) and absolute skeletal tissue mass (9.3% increase, p < 0.05) and volume (9.2% increase, p < 0.05) relative to controls. This was not observed when memantine treatment was combined with vitamin D enrichment. CONCLUSION Combination treatment of vitamin D and memantine had no negative effects on body composition. Future studies should clarify whether vitamin D status impacts the effects of memantine treatment on bone physiology in people with AD.
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Affiliation(s)
- Dickson Wong
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Dana N Broberg
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Jagroop Doad
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Joseph U Umoh
- Preclinical Imaging Research Centre, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Miranda Bellyou
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Chris J D Norley
- Preclinical Imaging Research Centre, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - David W Holdsworth
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Preclinical Imaging Research Centre, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, University of Western Ontario, London, ON, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Olivier Beauchet
- Department of Medicine, University of Montreal and McGill University, Montreal, QC, Canada
| | - Cedric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.,UPRES EA 4638, University of Angers, Angers, France
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
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Lewis JE, Poles J, Shaw DP, Karhu E, Khan SA, Lyons AE, Sacco SB, McDaniel HR. The effects of twenty-one nutrients and phytonutrients on cognitive function: A narrative review. J Clin Transl Res 2021; 7:575-620. [PMID: 34541370 PMCID: PMC8445631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM Brain health is becoming more important to the average person as the number of people with cognitive impairments, such as Alzheimer's disease (AD), is rising significantly. The current Food and Drug Administration-approved pharmacotherapeutics for dementia neither cure nor halt cognitive decline; they just delay the worsening cognitive impairment. This narrative review summarizes the effects of nutrients and phytonutrients on cognitive function. METHODS A comprehensive literature search of PubMed was performed to find clinical trials in humans that assessed the effects of nutrients and phytonutrients on cognitive function published in English between 2000 and 2021. Six independent reviewers evaluated the articles for inclusion in this review. RESULTS Ninety-six articles were summarized in this narrative review. In total 21 categories of nutrients and phytonutrients were included, i.e., α-lipoic acid, Bacopa monnieri, B vitamins, cholinergic precursors, vitamin D, vitamin E, Ginkgo biloba, ginseng, lion's mane mushroom, N-acetyl cysteine, omega-3 fatty acids, aloe polysaccharides, Rhodiola rosea, rosemary, saffron, tart cherries, turmeric, wild yam, Withania somnifera, xanthines, and zinc. Particular noteworthy effects on cognition included memory, recollection, attention, intelligence, vocabulary, recognition, response inhibition, arousal, performance enhancement, planning, creative thinking, reaction time, vigilance, task switching, orientation to time, place, and person, reading, writing, comprehension, accuracy, learning, information processing speed, executive function, mental flexibility, daily functioning, decrease in mental fatigue, and freedom from distractibility. Some nutrients and phytonutrients also improved mood and contentedness and reduced anxiety and the need for caregiving. These effects are not completely consistent or ubiquitous across all patient populations or health statuses. Adverse effects were minimal or nonexistent. CONCLUSION Due to the growing population of people with cognitive impairment and the lack of effective pharmacotherapeutics, it is prudent for those afflicted or their caregivers to find alternative treatments. Our narrative review shows that many of these nutrients and phytonutrients may be promising for treating some aspects of cognitive impairment, especially for people afflicted with AD. RELEVANCE FOR PATIENTS As demonstrated in a number of clinical trials, healthy adults and patients with various health challenges (e.g., AD, mild cognitive impairment, multiple sclerosis, and Parkinson's disease) exhibiting a wide range of severity in cognitive defects would be best served to consider multiple nutrients and phytonutrients to improve aspects of their cognitive function.
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Affiliation(s)
- John E. Lewis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jillian Poles
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delaney P. Shaw
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Elisa Karhu
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sher Ali Khan
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Annabel E. Lyons
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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Lee Y(A, Yoon S, Kim S, Youn YC. Association of 25-hydroxyvitamin D status with brain volume changes. Food Sci Nutr 2021; 9:4169-4175. [PMID: 34401068 PMCID: PMC8358372 DOI: 10.1002/fsn3.2382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/12/2021] [Accepted: 05/22/2021] [Indexed: 01/01/2023] Open
Abstract
Vitamin D is critical to brain function and its deficiency accelerates cognitive impairment. There is limited understanding of the brain-specific areas that undergo volume change in relation to blood vitamin D levels. The objective of this study was to evaluate the association between blood 25-hydroxyvitamin D (25(OH)D) concentration and structural changes in the brain. We analyzed structural three-dimensional T1 MRI images of 201 elderly individuals (mean age = 74.91 ± 9.21 years; 68.1% female; mean 25(OH)D = 18.05 nmol/L), with 10 community-based normal healthy subjects, 33 with subjective cognitive decline, 97 with mild cognitive impairment, and 61 with Alzheimer's disease (AD). To analyze the structural changes in the brain respective to blood 25(OH)D, multiple regression analyses were performed using voxel-based morphometry with age and total intracranial volume as covariates. Lower 25(OH)D level were associated with reduced brain volume in right olfactory, rectus GM regions (FWE-corr, p < .05) for entire subjects. For AD subjects, left parahippocampal, fusiform, and hippocampal areas were positively associated with 25(OH)D (FWE-corr, p < .05). Low blood 25(OH)D was associated with reduced volumes in olfactory and hippocampal regions in elderly patients with cognitive decline. Our results may provide insight into the neurological pathophysiology of vitamin D.
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Affiliation(s)
- Yeonjae (Angel) Lee
- Department of Psychological and Brain SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | - Sungjin Yoon
- Chung‐Ang University College of MedicineSeoulKorea
| | - SangYun Kim
- Deparment of NeurologySeoul National University College of Medicine and Seoul National University Bundang HospitalSeongnamGyeonggi‐doKorea
| | - Young Chul Youn
- Department of Neurology and Department of Medical InformaticsChung‐Ang University College of MedicineSeoulKorea
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13
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Mehrabadi S, Sadr SS. Administration of Vitamin D3 and E supplements reduces neuronal loss and oxidative stress in a model of rats with Alzheimer’s disease. Neurol Res 2020; 42:862-868. [DOI: 10.1080/01616412.2020.1787624] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Shima Mehrabadi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Shahabeddin Sadr
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Cooper J, Burrow S, Pusey H. What are the perceptions of people living with dementia, family carers, professionals and other potential stakeholders to the use of global positioning systems to promote safer outdoor walking?: a qualitative literature review. Disabil Rehabil Assist Technol 2019; 16:614-623. [PMID: 31711328 DOI: 10.1080/17483107.2019.1686074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Walking outdoors has many benefits which can improve quality of life for people living with dementia. However, due to the risk of getting lost, many people with dementia are denied the opportunity to be outdoors. There has been increased interest in using global positioning systems (GPS) to facilitate independent outdoor mobility for people with dementia, but this interest has been accompanied by ethical debate focussing on the rights of an individual with dementia to maintain privacy and autonomy. The objective was to establish what people, those with dementia, those who provide support for people with dementia and wider society perceive to be the issues around GPS use. Method: An adapted qualitative systematic review was conducted between November 2018 and December 2018. Medical, social and technological databases were searched for papers with no date restriction. Initial search terms displayed nine hundred and sixty citations. Titles and if necessary abstracts were read to determine which studies might be potentially relevant. Forty papers were identified as potentially relevant and their abstracts and references examined. This produced a further four potential studies. Following application of the exclusion criteria thirty papers were eliminated.Fourteen were accepted, appraised and thematically analyzed. Results: The ethical debate was reflected in the opinions of the study respondents. There was a willingness to relinquish some privacy for safety but people with dementia were not prepared to sacrifice their autonomy-believing they alone should decide whether GPS was appropriate. Conclusion: GPS was felt to have the potential to facilitate independent outdoor walking, but systems need to be tailored to the individual. There is also a need to contradict negative societal perceptions of the ability of people with dementia to live a fulfilled life which is in danger of diminishing GPS's potential to improve quality of life for people with dementia.Implications for RehabilitationWhilst dementia is a disabling and incurable disease, taking advantage of technological developments such as GPS can diminish its negative impact.Appropriate development and use of GPSs offers the potential to enable people with dementia to explore the outdoors independently with subsequent improvement in self-confidence, independence and autonomy.Professionals working with people with dementia need to be aware of the GPS technology available and the ethical issues involved to support the use of GPS.
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Affiliation(s)
- Janet Cooper
- Tameside and Glossop Integrated Care NHS Foundation Trust, Tameside General Hospital, Ashton-under-Lyne, UK
| | - Simon Burrow
- Faculty of Biology, Medicine and Health, Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen Pusey
- Faculty of Biology, Medicine and Health, Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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15
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Sanjari Moghaddam H, Ghazi Sherbaf F, Aarabi MH. Brain microstructural abnormalities in type 2 diabetes mellitus: A systematic review of diffusion tensor imaging studies. Front Neuroendocrinol 2019; 55:100782. [PMID: 31401292 DOI: 10.1016/j.yfrne.2019.100782] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/27/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with deficits in the structure and function of the brain. Diffusion tensor imaging (DTI) is a highly sensitive method for characterizing cerebral tissue microstructure. Using PRISMA guidelines, we identified 29 studies which have demonstrated widespread brain microstructural impairment and topological network disorganization in patients with T2DM. Most consistently reported structures with microstructural abnormalities were frontal, temporal, and parietal lobes in the lobar cluster; corpus callosum, cingulum, uncinate fasciculus, corona radiata, and internal and external capsules in the white matter cluster; thalamus in the subcortical cluster; and cerebellum. Microstructural abnormalities were correlated with pathological derangements in the endocrine profile as well as deficits in cognitive performance in the domains of memory, information-processing speed, executive function, and attention. Altogether, the findings suggest that the detrimental effects of T2DM on cognitive functions might be due to microstructural disruptions in the central neural structures.
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Affiliation(s)
| | - Farzaneh Ghazi Sherbaf
- Neuroradiology Division, Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Neuroradiology Division, Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
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16
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Wang Y, Wang Y, Zhang B, Lin Y, Tan S, Lu Z. Depressed Serum 25-Hydroxyvitamin D Levels Increase Hospital Stay and Alter Glucose Homeostasis in First-ever Ischemic Stroke. Curr Neurovasc Res 2019; 16:340-347. [PMID: 31549956 DOI: 10.2174/1567202616666190924161947] [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: 07/01/2019] [Revised: 07/27/2019] [Accepted: 08/04/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Vitamin D deficiency is internationally recognized among the potentially modifiable risk factors for ischemic cardio-cerebrovascular diseases. However, the association between vitamin D deficiency and stroke morbidity or mortality remains insufficiently known. Our aim is to investigate their relevance to 25-hydroxyvitamin D [25(OH) D] levels and clinical severity and outcome after 3 months in first-ever ischemic stroke. METHODS Retrospective analysis of 356 consecutive patients in first-ever ischemic stroke between 2013 and 2015. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome after 3 months of onset was evaluated using the modified Rankin scale (mRS). RESULTS Among the 356 enrolled patients, HbA1c was higher in insufficiency/deficiency group than that in the sufficiency group (6.3 ± 1.7 vs. 5.9 ± 1.1, p =0.015). The hospital stay was longer in insufficiency/deficiency group than that in the sufficiency group (11 (8-17) vs. 9.5 (7-13), p = 0.035). There was a significant inversed trend between serum 25(OH) D levels and hospital stay (OR 0.960, P = 0.031), using logistic regression. CONCLUSION 25(OH)D levels are associated with glucose homeostasis, 25(OH) D contributes to increase the length of hospital stay. Low serum 25-OHD level is an independent predictor for hospital stay in first-ever ischemic stroke. Vitamin D deficiency did not predict functional outcome in the span of 3 months.
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Affiliation(s)
- Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanqiang Wang
- Department of Neurology, The Affiliated Hospital of Wei Fang Medical University, Weifang, China
| | - Bingjun Zhang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yinyao Lin
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sha Tan
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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17
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Profiling of Alzheimer’s disease related genes in mild to moderate vitamin D hypovitaminosis. J Nutr Biochem 2019; 67:123-137. [DOI: 10.1016/j.jnutbio.2019.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 12/13/2018] [Accepted: 01/29/2019] [Indexed: 02/01/2023]
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Gamage MWK, Hewage C, Pathirana KD. Associated factors for cognition of physically independent elderly people living in residential care facilities for the aged in Sri Lanka. BMC Psychiatry 2019; 19:10. [PMID: 30621644 PMCID: PMC6325741 DOI: 10.1186/s12888-018-2003-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 12/26/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND As the elderly population and prevalence of dementia is increasing, it is necessary to have a better comprehension of the influence of specific factors on cognitive function. Dementia is not an inevitable consequence of ageing. Lifestyle factors might either increase or decrease the risk. Even though different studies have focused on individual factors, only a few studies are available which assess all these factors as a whole. Available evidence on these factors is mainly from high income countries and much less evidence is available from low and middle income countries. As cognition is critical for elderly people to engage in a physically independent life, we aimed to identify the associated factors of cognition. METHODS This was a descriptive cross sectional study performed with 421 elderly people dwelling in residential care facilities for the aged in two selected districts in the Southern Province of Sri Lanka. Cognition was assessed using the Mini Mental State Examination (MMSE). Independent sample t test, ANOVA and regression analyses were used to explore associated factors for cognition. The statistical significance was kept at bonferroni adjusted p < 0.004. RESULTS The study included elderly people with a mean age of 71.9 ± 6.7 years and of them 65.8% were females. Factors affecting higher level of cognition were, having upper secondary, advanced and higher education; being married; arriving at the facility on one's own accord; being visited by family members; higher physical activity levels and engaging in social and leisure activities (p < 0.004). The factors, namely physical activity level, educational status, visits by family members and engaging in leisure activities were the predictors of cognition in the regression model. CONCLUSION Though there were several factors that associated with the level of cognition such as educational status, marital status, reason for attending the facility, visits by family members, physical activity levels and participation in social and leisure activities, only the factors, such as physical activity levels, visits by family members, educational status and engaging in leisure activities were the predictors of cognition.
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Affiliation(s)
| | - Chandana Hewage
- Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.
| | - Kithsiri Dedduwa Pathirana
- 0000 0001 0103 6011grid.412759.cDepartment of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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Yao Y, Fu S, Shi Q, Zhang H, Zhu Q, Zhang F, Luan F, Zhao Y, He Y. Prevalence of functional dependence in Chinese centenarians and its relationship with serum vitamin D status. Clin Interv Aging 2018; 13:2045-2053. [PMID: 30410320 PMCID: PMC6200073 DOI: 10.2147/cia.s182318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Functional dependence (FD) and vitamin D deficiency are common conditions in older adults. However, little is known about the relationship between FD and serum vitamin D status in centenarians. The current study was designed to evaluate the prevalence of FD and examine its relationship with serum vitamin D status among centenarians in China. Subjects and methods A cross-sectional study of a large sample of Chinese centenarians including 180 men and 822 women was conducted from June 2014 to December 2016. Home interviews, physical examinations, and blood analyses were performed in 958 centenarians following standard procedures. FD was evaluated using the Barthel index of activities of daily living (ADL). Serum 25-hydroxyvitamin D (25OHD) concentrations were measured as a marker of vitamin D status. Results The prevalence of centenarians with FD was 71.2%. Vitamin D deficiency, lack of tea consumption, lack of outdoor activities, visual impairment, and fracture were predictors of FD. Centenarians in the lowest quartile of serum 25OHD concentration had an approximately threefold greater likelihood of FD than those in the highest quartile in multiple logistic regression models (OR =2.88; 95% CI 1.75–4.73; P<0.001). The multivariable OR with a 1 ng/mL decrease in serum 25OHD concentration was 1.06 (95% CI 1.04–1.08; P<0.001) for FD. Conclusion Serum 25OHD levels have important associations with FD in Chinese centenarians. Future research could focus on the value of intervening in the case of low serum 25OHD levels through vitamin D supplementation and improving ADL in the older population.
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Affiliation(s)
- Yao Yao
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People's Republic of China,
| | - Shihui Fu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Qiuling Shi
- Department of Symptom Research, MD Anderson Cancer Center, Houston, TX, USA
| | - Hao Zhang
- Department of Health Policy and Management, Texas A&M University, College Station, TX, USA
| | - Qiao Zhu
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China,
| | - Fu Zhang
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China,
| | - Fuxin Luan
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China,
| | - Yali Zhao
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China,
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People's Republic of China,
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20
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Yao Y, Fu S, Zhang H, Li N, Zhu Q, Zhang F, Luan F, Zhao Y, He Y. The prevalence of depressive symptoms in Chinese longevous persons and its correlation with vitamin D status. BMC Geriatr 2018; 18:198. [PMID: 30157761 PMCID: PMC6114877 DOI: 10.1186/s12877-018-0886-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 08/16/2018] [Indexed: 01/04/2023] Open
Abstract
Background Hypovitaminosis D and depressive syndromes are common conditions in old adults. However, little is known about the relationship between vitamin D and depression in exceptional aged people. The objective of this study is to evaluate the relationship between vitamin D levels and depressive symptoms in Chinese longevous persons. Methods We used a dataset from a cross-sectional survey of a sample of Chinese longevous people with self-reported age 100 or older, including 175 men and 765 women, was conducted from June 2014 to December 2016 in Hainan Province, China. Data on demographics, lifestyle characteristics and health conditions were collected using a structured questionnaire. Anthropometrics and blood samples were obtained following the standard procedure. Depressive symptoms of the participants were assessed using a shortened version of the Geriatric Depression Scale (GDS-15). Serum vitamin D levels were measured using an automated radioimmunoassay. Results The prevalence of longevous persons with depressive symptoms among the sample was 32.2% (95% confidence interval: 29.7–34.7%). Serum vitamin D levels were lower in participants with depressive symptoms than in those without (20.8 ± 8.7 vs. 23.7 ± 9.7, ng/mL). Vitamin D deficiency was an independent risk factor for depression after controlling for the potential covariates (Odds ratio = 1.47, 95% Confidence interval = 1.08–2.00; p = 0.014). A negative relationship between serum vitamin D levels and depressive symptoms was also detected, and the relationship remained significant after adjusting for a wide range of other covariates. The multivariate adjusted odds ratio of depressive symptoms for the lowest versus highest quartiles of vitamin D levels was 1.73 (95% confidence interval: 1.10–2.72), and the adjusted odds ratio with a 5 ng/mL decrement of serum 25OHD levels was 1.10 (95% confidence interval: 1.01–1.19). Conclusions This study showed an inverse association between vitamin D levels and depressive symptoms among Chinese longevous persons. Depressive symptoms should be screened in longevous persons who had vitamin D deficiency. Further studies on vitamin D supplement and prevention along with treatment of depression are needed among very old population.
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Affiliation(s)
- Yao Yao
- Institute of Geriatrics, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shihui Fu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.,Department of Cardiology, Hainan Branch of Chinese PLA General Hospital, Sanya, China
| | - Hao Zhang
- Department of health policy and management, Texas A&M University, College Station, USA
| | - Nan Li
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Qiao Zhu
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Jianglin Road 9, Sanya, 572000, People's Republic of China
| | - Fu Zhang
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Jianglin Road 9, Sanya, 572000, People's Republic of China
| | - Fuxin Luan
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Jianglin Road 9, Sanya, 572000, People's Republic of China
| | - Yali Zhao
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Jianglin Road 9, Sanya, 572000, People's Republic of China.
| | - Yao He
- Institute of Geriatrics, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China. .,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Beijing, China. .,National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, Beijing, China.
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Supriya M, Chandra SR, Prabhakar P, Prasad C, Christopher R. Vitamin D receptor ( VDR ) gene polymorphism and vascular dementia due to cerebral small vessel disease in an Asian Indian cohort. J Neurol Sci 2018; 391:84-89. [DOI: 10.1016/j.jns.2018.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/02/2018] [Accepted: 05/30/2018] [Indexed: 12/29/2022]
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22
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Zhang Y, Shan GJ, Zhang YX, Cao SJ, Zhu SN, Li HJ, Ma D, Wang DX. Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub-analysis. Acta Anaesthesiol Scand 2018; 62:924-935. [PMID: 29578249 DOI: 10.1111/aas.13116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 02/23/2018] [Accepted: 03/04/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Vitamin D is important for maintaining physiological functions including cognition and its deficiency is associated with the occurrence of cognitive impairment. This study was to explore the association between preoperative vitamin D status and the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients undergoing major surgery. METHODS This was a predefined exploratory sub-analysis of one-centre data from a randomized controlled trial. In all, 123 elderly (≥ 65 years) patients who were scheduled to undergo major cancer surgery were recruited. Serum 25-hydroxyvitamin D concentration was measured before surgery. In total, 59 nonsurgical control subjects with comparable age and education level were also enrolled. A battery of neuropsychological tests was administered the day before and the 7th day after surgery in patients or at the same time interval in control subjects. POCD was diagnosed according to the ISPOCD1 definition. RESULTS 71.5% (88/123) of elderly patients had vitamin D deficiency (serum 25-hydroxyvitamin D concentration < 12 ng/ml) before surgery; 24.4% (30/123) of them developed cognitive dysfunction at 1 week after surgery. After adjusting for confounding factors, high preoperative serum 25-hydroxyvitamine D concentration was related to a decreased risk of POCD (odds ratio [OR]: 0.829, 95% confidence interval [CI]: 0.708-0.971; P = 0.020), whereas preoperative vitamin D deficiency was associated with an increased risk of POCD (OR: 8.427, 95% CI: 1.595-44.511; P = 0.012). CONCLUSIONS Vitamin D deficiency is prevalent in elderly patients undergoing major cancer surgery and increases the risk of early POCD development. Whether prophylactic vitamin D supplementation can reduce POCD in the elderly deserves further study.
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Affiliation(s)
- Y. Zhang
- Department of Anaesthesiology and Critical Care Medicine; Peking University First Hospital; Beijing China
| | - G.-J. Shan
- Department of Anaesthesiology and Critical Care Medicine; Peking University First Hospital; Beijing China
| | - Y.-X. Zhang
- Department of Anaesthesiology and Critical Care Medicine; Peking University First Hospital; Beijing China
| | - S.-J. Cao
- Department of Anaesthesiology and Critical Care Medicine; Peking University First Hospital; Beijing China
| | - S.-N. Zhu
- Department of Biostatics; Peking University First Hospital; Beijing China
| | - H.-J. Li
- Peking University Clinical Research Institute; Beijing China
| | - D. Ma
- Section of Anaesthetics, Pain Medicine and Intensive Care; Department of Surgery and Cancer; Faculty of Medicine; Chelsea and Westminster Hospital; Imperial College London; London UK
| | - D.-X. Wang
- Department of Anaesthesiology and Critical Care Medicine; Peking University First Hospital; Beijing China
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Lerner PP, Sharony L, Miodownik C. Association between mental disorders, cognitive disturbances and vitamin D serum level: Current state. Clin Nutr ESPEN 2018; 23:89-102. [DOI: 10.1016/j.clnesp.2017.11.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 07/31/2017] [Accepted: 11/29/2017] [Indexed: 01/02/2023]
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Sher L. Commentary: Vitamin D Deficiency Associated with Cognitive Functioning in Psychotic Disorders. Front Public Health 2018; 5:351. [PMID: 29312921 PMCID: PMC5742573 DOI: 10.3389/fpubh.2017.00351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 12/11/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Leo Sher
- James J. Peters Veterans' Administration Medical Center and Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Grimm MOW, Thiel A, Lauer AA, Winkler J, Lehmann J, Regner L, Nelke C, Janitschke D, Benoist C, Streidenberger O, Stötzel H, Endres K, Herr C, Beisswenger C, Grimm HS, Bals R, Lammert F, Hartmann T. Vitamin D and Its Analogues Decrease Amyloid-β (Aβ) Formation and Increase Aβ-Degradation. Int J Mol Sci 2017; 18:E2764. [PMID: 29257109 PMCID: PMC5751363 DOI: 10.3390/ijms18122764] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/01/2017] [Accepted: 12/13/2017] [Indexed: 12/11/2022] Open
Abstract
Alzheimer's disease (AD) is characterized by extracellular plaques in the brain, mainly consisting of amyloid-β (Aβ), as derived from sequential cleavage of the amyloid precursor protein. Epidemiological studies suggest a tight link between hypovitaminosis of the secosteroid vitamin D and AD. Besides decreased vitamin D level in AD patients, an effect of vitamin D on Aβ-homeostasis is discussed. However, the exact underlying mechanisms remain to be elucidated and nothing is known about the potential effect of vitamin D analogues. Here we systematically investigate the effect of vitamin D and therapeutically used analogues (maxacalcitol, calcipotriol, alfacalcidol, paricalcitol, doxercalciferol) on AD-relevant mechanisms. D₂ and D₃ analogues decreased Aβ-production and increased Aβ-degradation in neuroblastoma cells or vitamin D deficient mouse brains. Effects were mediated by affecting the Aβ-producing enzymes BACE1 and γ-secretase. A reduced secretase activity was accompanied by a decreased BACE1 protein level and nicastrin expression, an essential component of the γ-secretase. Vitamin D and analogues decreased β-secretase activity, not only in mouse brains with mild vitamin D hypovitaminosis, but also in non-deficient mouse brains. Our results further strengthen the link between AD and vitamin D, suggesting that supplementation of vitamin D or vitamin D analogues might have beneficial effects in AD prevention.
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Affiliation(s)
- Marcus O W Grimm
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
- Neurodegeneration and Neurobiology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
- Deutsches Institut für DemenzPrävention (DIDP), Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Andrea Thiel
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Anna A Lauer
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Jakob Winkler
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Johannes Lehmann
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
- Department of Internal Medicine II-Gastroenterology, Saarland University Hospital, Saarland University, Kirrberger Str. 100, 66421 Homburg/Saar, Germany.
| | - Liesa Regner
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Christopher Nelke
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Daniel Janitschke
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Céline Benoist
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Olga Streidenberger
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Hannah Stötzel
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Kristina Endres
- Department of Psychiatry and Psychotherapy, Clinical Research Group, University Medical Centre Johannes Gutenberg, University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.
| | - Christian Herr
- Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Christoph Beisswenger
- Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Heike S Grimm
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Robert Bals
- Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
| | - Frank Lammert
- Department of Internal Medicine II-Gastroenterology, Saarland University Hospital, Saarland University, Kirrberger Str. 100, 66421 Homburg/Saar, Germany.
| | - Tobias Hartmann
- Experimental Neurology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
- Neurodegeneration and Neurobiology, Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
- Deutsches Institut für DemenzPrävention (DIDP), Saarland University, Kirrberger Str. 1, 66421 Homburg/Saar, Germany.
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Li C, Hansen RA, Chou C, Calderón AI, Qian J. Trends in botanical dietary supplement use among US adults by cancer status: The National Health and Nutrition Examination Survey, 1999 to 2014. Cancer 2017; 124:1207-1215. [PMID: 29211315 DOI: 10.1002/cncr.31183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/10/2017] [Accepted: 11/18/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patients with cancer may use botanical dietary supplements (BDS) in an attempt to manage the side effects of chemotherapy, yet evidence about BDS use among patients with cancer is limited. The authors examined trends in BDS use among US adults according to cancer status and patient characteristics. METHODS A serial, cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey from 1999 through 2014 (n = 43,644). Self-reported cancer diagnosis history and any BDS use in the preceding 30 days were determined. The prevalence of BDS use was calculated in each cycle for respondents with and without cancer, both overall and by patient characteristics. Simple linear regression models were applied to test for trends in BDS use at a 2-sided P value < .05. Multiple logistic regression models were performed to identify the patient factors associated with BDS use. The results were weighted to represent national estimates. RESULTS The prevalence of BDS use was greater among participants who had cancer compared with participants who did not have cancer, but trends remained stable during 1999 through 2014 for both groups. Trends in BDS use declined in patients with cancer who were older (Ptrend = .047), had a low annual family income (Ptrend = .028), and had a lower education level (Ptrend = .004). Among the respondents without cancer, trends in BDS use declined in those who were middle-aged (Ptrend = .025), non-Hispanic whites (Ptrend = .025), those with a lower education level (Ptrend = .011), and those who were not receiving prescription medication (Ptrend = .036). Patient age, sex, race/ethnicity, income, education, and health conditions were associated with BDS use. CONCLUSIONS The overall use of BDS remained stable during 1999 through 2014 for US adults with and without cancer, but it varied by individual characteristics. Cancer 2018;124:1207-15. © 2017 American Cancer Society.
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Affiliation(s)
- Chao Li
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, Alabama
| | - Richard A Hansen
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, Alabama
| | - Chiahung Chou
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, Alabama
| | - Angela I Calderón
- Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, Alabama
| | - Jingjing Qian
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, Alabama
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Macpherson H, Formica M, Harris E, Daly RM. Brain functional alterations in Type 2 Diabetes - A systematic review of fMRI studies. Front Neuroendocrinol 2017; 47:34-46. [PMID: 28687473 DOI: 10.1016/j.yfrne.2017.07.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/30/2017] [Accepted: 07/02/2017] [Indexed: 02/07/2023]
Abstract
Type 2 Diabetes (T2DM) is emerging as a major global health issue. T2DM can adversely affect cognition and increase dementia risk. This systematic review aimed to examine the functional brain changes that may underlie cognitive dysfunction in adults with T2DM. Studies were restricted to those which used functional magnetic resonance imaging (fMRI). Nineteen independent studies were identified, mostly comprised of middle aged or older adults. Resting-state studies demonstrated that compared to controls, connectivity of the Default Mode Network (DMN) was reduced and the majority of task-based studies identified reduced activation in T2DM patients in regions relevant to task performance. Abnormalities of low frequency spontaneous brain activity were observed, particularly in visual regions. As most studies demonstrated that alterations in fMRI were related to poorer neuropsychological task performance, these results indicate that functional brain abnormalities in T2DM have consequences for cognition.
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Affiliation(s)
- Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.
| | - Melissa Formica
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Elizabeth Harris
- Centre for Human Psychopharmacology, Swinburne University, Hawthorn, VIC, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Solfrizzi V, Custodero C, Lozupone M, Imbimbo BP, Valiani V, Agosti P, Schilardi A, D’Introno A, La Montagna M, Calvani M, Guerra V, Sardone R, Abbrescia DI, Bellomo A, Greco A, Daniele A, Seripa D, Logroscino G, Sabbá C, Panza F. Relationships of Dietary Patterns, Foods, and Micro- and Macronutrients with Alzheimer’s Disease and Late-Life Cognitive Disorders: A Systematic Review. J Alzheimers Dis 2017; 59:815-849. [DOI: 10.3233/jad-170248] [Citation(s) in RCA: 179] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Carlo Custodero
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Bruno P. Imbimbo
- Department of Research and Development, Chiesi Farmaceutici, Parma, Italy
| | - Vincenzo Valiani
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Pasquale Agosti
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Andrea Schilardi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Alessia D’Introno
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Maddalena La Montagna
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Mariapaola Calvani
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Vito Guerra
- National Institute for Digestive Diseases, IRCCS “Saverio de Bellis”, Castellana, Bari, Italy
| | - Rodolfo Sardone
- National Institute for Digestive Diseases, IRCCS “Saverio de Bellis”, Castellana, Bari, Italy
| | - Daniela I. Abbrescia
- National Institute for Digestive Diseases, IRCCS “Saverio de Bellis”, Castellana, Bari, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Antonio Greco
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Davide Seripa
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy
| | - Carlo Sabbá
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
- Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy
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Matchar DB, Chei CL, Yin ZX, Koh V, Chakraborty B, Shi XM, Zeng Y. Vitamin D Levels and the Risk of Cognitive Decline in Chinese Elderly People: the Chinese Longitudinal Healthy Longevity Survey. J Gerontol A Biol Sci Med Sci 2016; 71:1363-8. [PMID: 27412894 PMCID: PMC5018565 DOI: 10.1093/gerona/glw128] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 06/19/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Vitamin D has a neuroprotective function, potentially important for the prevention of cognitive decline. Prospective studies from Western countries support an association between lower vitamin D level and future cognitive decline in elderly people. No prospective study has examined this association in Asia. METHODS This community-based cohort study of elderly people in China follows 1,202 cognitively intact adults aged ≥60 years for a mean duration of 2 years. Plasma vitamin D level was measured at the baseline. Cognitive state of participants was assessed using the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as an MMSE score <18. Cognitive decline was defined as ≥3 points decline from baseline. Multivariable logistic regression models were used to examine the association between quartiles of vitamin D levels with cognitive decline and incidence of cognitive impairment. RESULTS Participants with low vitamin D level had an increased risk of cognitive decline. Compared with the highest quartile of vitamin D levels, the multivariable odds ratios (ORs; 95% confidence interval) for cognitive decline were 2.1 (1.3-3.4) for the second highest quartile, 2.2 (1.4-3.6) for the third highest quartile, and 2.0 (1.2-3.3) for the lowest quartile. The multivariable ORs of incident cognitive impairment for the second highest, third highest, and lowest versus highest quartiles of vitamin D levels were 1.9 (0.9-4.1), 2.6 (1.2-5.6), and 3.2 (1.5-6.6), respectively. CONCLUSIONS This first follow-up study of elderly people, including the oldest-old, in Asia shows that low vitamin D levels were associated with increased risk of subsequent cognitive decline and impairment.
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Affiliation(s)
- David B Matchar
- Health Services and Systems Research, Duke-NUS Medical School, Singapore. Department of Medicine, Duke University School of Medicine, Durham, North Carolina.
| | - Choy-Lye Chei
- Health Services and Systems Research, Duke-NUS Medical School, Singapore. Department of Public Health Medicines, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Victoria Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | | | - Xiao-Ming Shi
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zeng
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, North Carolina. Center for Healthy Aging and Development Studies, National School of Development, Raissun Institute for Advanced Studies, Peking University, Beijing, China
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Qato DM, Wilder J, Schumm LP, Gillet V, Alexander GC. Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. JAMA Intern Med 2016; 176:473-82. [PMID: 26998708 PMCID: PMC5024734 DOI: 10.1001/jamainternmed.2015.8581] [Citation(s) in RCA: 356] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
IMPORTANCE Prescription and over-the-counter medicines and dietary supplements are commonly used, alone and together, among older adults. However, the effect of recent regulatory and market forces on these patterns is not known. OBJECTIVES To characterize changes in the prevalence of medication use, including concurrent use of prescription and over-the-counter medications and dietary supplements, and to quantify the frequency and types of potential major drug-drug interactions. DESIGN, SETTING, AND PARTICIPANTS Descriptive analyses of a longitudinal, nationally representative sample of community-dwelling older adults 62 to 85 years old. In-home interviews with direct medication inspection were conducted in 2005-2006 and again in 2010-2011. The dates of the analysis were March to November 2015. We defined medication use as the use of at least 1 prescription or over-the-counter medication or dietary supplement at least daily or weekly and defined concurrent use as the regular use of at least 2 medications. We used Micromedex to identify potential major drug-drug interactions. MAIN OUTCOMES AND MEASURES Population estimates of the prevalence of medication use (in aggregate and by therapeutic class), concurrent use, and major drug-drug interactions. RESULTS The study cohort comprised 2351 participants in 2005-2006 and 2206 in 2010-2011. Their mean age was 70.9 years in 2005-2006 and 71.4 years in 2010-2011. Fifty-three percent of participants were female in 2005-2006, and 51.6% were female in 2010-2011. The use of at least 1 prescription medication slightly increased from 84.1% in 2005-2006 to 87.7% in 2010-2011 (P = .003). Concurrent use of at least 5 prescription medications increased from 30.6% to 35.8% (P = .02). While the use of over-the-counter medications declined from 44.4% to 37.9%, the use of dietary supplements increased from 51.8% to 63.7% (P < .001 for both). There were clinically significant increases in the use of statins (33.8% to 46.2%), antiplatelets (32.8% to 43.0%), and omega-3 fish oils (4.7% to 18.6%) (P < .05 for all). In 2010-2011, approximately 15.1% of older adults were at risk for a potential major drug-drug interaction compared with an estimated 8.4% in 2005-2006 (P < .001). Most of these interacting regimens involved medications and dietary supplements increasingly used in 2010-2011. CONCLUSIONS AND RELEVANCE In this study, the use of prescription medications and dietary supplements, and concurrent use of interacting medications, has increased since 2005, with 15% of older adults potentially at risk for a major drug-drug interaction. Improving safety with the use of multiple medications has the potential to reduce preventable adverse drug events associated with medications commonly used among older adults.
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Affiliation(s)
- Dima M Qato
- Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois at Chicago2Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health
| | - Jocelyn Wilder
- Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois at Chicago2Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health
| | - L Philip Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Victoria Gillet
- currently a medical student at the School of Medicine, University of Chicago, Chicago, Illinois
| | - G Caleb Alexander
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland6Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Hoel DG, Berwick M, de Gruijl FR, Holick MF. The risks and benefits of sun exposure 2016. DERMATO-ENDOCRINOLOGY 2016; 8:e1248325. [PMID: 27942349 PMCID: PMC5129901 DOI: 10.1080/19381980.2016.1248325] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/11/2016] [Indexed: 01/10/2023]
Abstract
Public health authorities in the United States are recommending that men, women and children reduce their exposure to sunlight, based on concerns that this exposure will promote skin cancer. On the other hand, data show that increasing numbers of Americans suffer from vitamin D deficiencies and serious health problems caused by insufficient sun exposure. The body of science concerning the benefits of moderate sun exposure is growing rapidly, and is causing a different perception of sun/UV as it relates to human health. Melanoma and its relationship to sun exposure and sunburn is not adequately addressed in most of the scientific literature. Reports of favorable health outcomes related to adequate serum 25(OH)D concentration or vitamin D supplementation have been inappropriately merged, so that benefits of sun exposure other than production of vitamin D are not adequately described. This review of recent studies and their analyses consider the risks and benefits of sun exposure which indicate that insufficient sun exposure is an emerging public health problem. This review considers the studies that have shown a wide range health benefits from sun/UV exposure. These benefits include among others various types of cancer, cardiovascular disease, Alzheimer disease/dementia, myopia and macular degeneration, diabetes and multiple sclerosis. The message of sun avoidance must be changed to acceptance of non-burning sun exposure sufficient to achieve serum 25(OH)D concentration of 30 ng/mL or higher in the sunny season and the general benefits of UV exposure beyond those of vitamin D.
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Affiliation(s)
- David G. Hoel
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Marianne Berwick
- Department of Internal Medicine and University of New Mexico Cancer Center, Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA
| | - Frank R. de Gruijl
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael F. Holick
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University Medical Center, Boston, MA, USA
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Kuźma E, Soni M, Littlejohns TJ, Ranson JM, van Schoor NM, Deeg DJH, Comijs H, Chaves PHM, Kestenbaum BR, Kuller LH, Lopez OL, Becker JT, Langa KM, Henley WE, Lang IA, Ukoumunne OC, Llewellyn DJ. Vitamin D and Memory Decline: Two Population-Based Prospective Studies. J Alzheimers Dis 2016; 50:1099-108. [PMID: 26836174 PMCID: PMC5525144 DOI: 10.3233/jad-150811] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Vitamin D deficiency has been linked with dementia risk, cognitive decline, and executive dysfunction. However, the association with memory remains largely unknown. OBJECTIVE To investigate whether low serum 25-hydroxyvitamin D (25(OH)D) concentrations are associated with memory decline. METHODS We used data on 1,291 participants from the US Cardiovascular Health Study (CHS) and 915 participants from the Dutch Longitudinal Aging Study Amsterdam (LASA) who were dementia-free at baseline, had valid vitamin D measurements, and follow-up memory assessments. The Benton Visual Retention Test (in the CHS) and Rey's Auditory Verbal Learning Test (in the LASA) were used to assess visual and verbal memory, respectively. RESULTS In the CHS, those moderately and severely deficient in serum 25(OH)D changed -0.03 SD (95% CI: -0.06 to 0.01) and -0.10 SD (95% CI: -0.19 to -0.02) per year respectively in visual memory compared to those sufficient (p = 0.02). In the LASA, moderate and severe deficiency in serum 25(OH)D was associated with a mean change of 0.01 SD (95% CI: -0.01 to 0.02) and -0.01 SD (95% CI: -0.04 to 0.02) per year respectively in verbal memory compared to sufficiency (p = 0.34). CONCLUSIONS Our findings suggest an association between severe vitamin D deficiency and visual memory decline but no association with verbal memory decline. They warrant further investigation in prospective studies assessing different memory subtypes.
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Affiliation(s)
| | - Maya Soni
- University of Exeter Medical School, Exeter, UK
| | - Thomas J. Littlejohns
- University of Exeter Medical School, Exeter, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, UK
| | | | - Natasja M. van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J. H. Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Hannie Comijs
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Paulo H. M. Chaves
- Benjamin Leon Center for Geriatric Research and Education, Florida International University, Miami, USA
| | - Bryan R. Kestenbaum
- Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, USA
| | - Lewis H. Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA
| | - Oscar L. Lopez
- Department of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - James T. Becker
- Department of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Kenneth M. Langa
- Division of General Medicine, Veterans Affairs Ann Arbor Center for Clinical Management Research, Institute for Social Research, and Institute for Healthcare Policy and Innovation, University of Michigan, all in Ann Arbor, USA
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Keeney JT, Butterfield DA. Vitamin D deficiency and Alzheimer disease: Common links. Neurobiol Dis 2015; 84:84-98. [DOI: 10.1016/j.nbd.2015.06.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 12/31/2022] Open
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Gao LH, Zhu WJ, Liu YJ, Gu JM, Zhang ZL, Wang O, Xing XP, Xu L. Physical performance and life quality in postmenopausal women supplemented with vitamin D: a two-year prospective study. Acta Pharmacol Sin 2015; 36:1065-73. [PMID: 26279157 DOI: 10.1038/aps.2015.55] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/28/2015] [Indexed: 01/21/2023] Open
Abstract
AIM To investigate the effects of calcium and vitamin D supplementation on bone turnover marker levels, muscle strength and quality of life in postmenopausal Chinese women. METHODS A total of 485 healthy postmenopausal Chinese women (63.44±5.04 years) were enrolled in this open-label, 2-year, prospective, community-based trial. The participants were divided into group A, B, C, which were treated with calcium (600 mg/d) alone, calcium (600 mg/d) and cholecalciferol (800 IU/d) or calcium (600 mg/d) and calcitriol (0.25 μg/d), respectively, for 2 years. Serum levels of 25-hydroxyvitamin D, parathyroid hormone, β-CTX and P1NP were measured, and the muscle strength and quality of life were assessed at baseline and at 12- and 24-month follow-ups. RESULTS Four hundred and sixty one participants completed this study. Serum levels of 25-hydroxyvitamin D were significantly increased in group C, but not changed in groups A and B at 24-month follow-up. Serum levels of parathyroid hormone, bone turnover marker β-CTX and bone formation marker P1NP were significantly decreased in group C, while serum levels of β-CTX were increased in group A at 24-month follow-up. The participants in group C maintained the grip strength, while those in groups A and B exhibited decreased grip strength at 24-month follow-up. The quality of life for the participants in groups B and C remained consistent, but that in group A was deteriorated at 24-month follow-up. CONCLUSION Supplementation with calcitriol and calcium modifies the bone turnover marker levels, and maintains muscle strength and quality of life in postmenopausal Chinese women, whereas supplementation with cholecalciferol and calcium prevents aging-mediated deterioration in quality of life.
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Shen L, Ji HF. Vitamin D deficiency is associated with increased risk of Alzheimer's disease and dementia: evidence from meta-analysis. Nutr J 2015; 14:76. [PMID: 26231781 PMCID: PMC4522102 DOI: 10.1186/s12937-015-0063-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 07/27/2015] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, the associations between vitamin D status and Alzheimer’s disease (AD) and dementia have gained increasing interests. The present meta-analysis was designed to estimate the association between vitamin D deficiency and risk of developing AD and dementia. Methods A literature search conducted until February 2015 identified 10 study populations, which were included in the meta-analysis. Pooled risk ratios (RRs) and 95 % confidence interval (CI) were calculated with a random-effect model using Stata software package. Results Results of our meta-analysis showed that subjects with deficient vitamin D status (25(OH)D level < 50 nmol/L) were at increased risk of developing AD by 21 % compared with those possessing 25(OH)D level > 50 nmol/L. Similar analysis also found a significantly increased dementia risk in vitamin D deficient subjects. There is no evidence for significant heterogeneity among the included studies. Conclusion Available data indicates that lower vitamin D status may be associated with increased risk of developing AD and dementia. More studies are needed to further confirm the associations and to evaluate the beneficial effects of vitamin D supplementation in preventing AD and dementia.
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Affiliation(s)
- Liang Shen
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, 255049, P. R. China
| | - Hong-Fang Ji
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, 255049, P. R. China.
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Annweiler C, Dursun E, Féron F, Gezen-Ak D, Kalueff AV, Littlejohns T, Llewellyn DJ, Millet P, Scott T, Tucker KL, Yilmazer S, Beauchet O. 'Vitamin D and cognition in older adults': updated international recommendations. J Intern Med 2015; 277:45-57. [PMID: 24995480 DOI: 10.1111/joim.12279] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hypovitaminosis D, a condition that is highly prevalent in older adults aged 65 years and above, is associated with brain changes and dementia. Given the rapidly accumulating and complex contribution of the literature in the field of vitamin D and cognition, clear guidance is needed for researchers and clinicians. METHODS International experts met at an invitational summit on 'Vitamin D and Cognition in Older Adults'. Based on previous reports and expert opinion, the task force focused on key questions relating to the role of vitamin D in Alzheimer's disease and related disorders. Each question was discussed and voted using a Delphi-like approach. RESULTS The experts reached an agreement that hypovitaminosis D increases the risk of cognitive decline and dementia in older adults and may alter the clinical presentation as a consequence of related comorbidities; however, at present, vitamin D level should not be used as a diagnostic or prognostic biomarker of Alzheimer's disease due to lack of specificity and insufficient evidence. This population should be screened for hypovitaminosis D because of its high prevalence and should receive supplementation, if necessary; but this advice was not specific to cognition. During the debate, the possibility of 'critical periods' during which vitamin D may have its greatest impact on the brain was addressed; whether hypovitaminosis D influences cognition actively through deleterious effects and/or passively by loss of neuroprotection was also considered. CONCLUSIONS The international task force agreed on five overarching principles related to vitamin D and cognition in older adults. Several areas of uncertainty remain, and it will be necessary to revise the proposed recommendations as new findings become available.
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Affiliation(s)
- C Annweiler
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France; Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, ON, Canada
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Yin Y, Fan Y, Lin F, Xu Y, Zhang J. Nutrient biomarkers and vascular risk factors in subtypes of mild cognitive impairment: a cross-sectional study. J Nutr Health Aging 2015; 19:39-47. [PMID: 25560815 DOI: 10.1007/s12603-014-0510-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the interrelationships among blood nutrient biomarkers, the Framingham Stroke Risk Profile (FSRP), and cognitive impairment features in mild cognitive impairment (MCI) subjects and to verify whether nutrient biomarkers and FSRP are risk factors for MCI. METHODS According to the criteria for MCI developed by Petersen, 81 subjects aged 50-80 years were divided into a normal control group (NC group, n = 36) and an MCI group (n = 45). Then, the MCI group was divided into an amnestic MCI (a-MCI) and a multidomain MCI (md-MCI) group. All subjects were administered a comprehensive health history to calculate their FSRP score and a thorough neuropsychological assessment of four cognitive domains. Blood samples from all subjects were collected to measure the nutrient biomarkers. RESULTS FSRP score was not only associated with memory function, but also with executive function, which itself had a negative relationship with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total n-3 polyunsaturated fatty acids (n-3PUFAs) levels, and a positive relationship with the ratio of n-6 PUFAs to n-3 PUFAs(n6/n3). Compared with the NC group, the concentrations of EPA, DHA, 25-hydroxy vitamin D (25OHD), and folate and the ratio of n3/n6 in the md-MCI group were significantly lower. In the a-MCI group, only DHA concentrations and the ratio of n3/n6 were significantly lower. After adjustment for potential confounding variables, low education level [Adjusted OR=8.71 (95%CI: 1.83-41.50), p trend = 0.007], decreased plasma 25OHD [Adjusted OR = 4.41 (95% CI: 1.08-17.94), p trend=0.04] and decreased plasma DHA [Adjusted OR = 6.69 (95% CI: 1.37-32.72), p = 0.02] were associated with a higher risk of MCI. CONCLUSIONS Several nutrient biomarkers in MCI patients, especially in md-MCI patients, were lower compared with healthy controls, suggesting that lower 25OHD and DHA levels are risk factors for MCI. However, we found no evidence that FSRP is an early biomarker of MCI.
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Affiliation(s)
- Y Yin
- Junjian Zhang, Department of Neurology, Zhongnan Hospital, Wuhan University, No.169, Donghu Road, Wuhan 430071, Hubei, China, Tel. +86 139 86225751, E-Mail:
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Abstract
The number of individuals aged 65 and older is expected to more than double from 2012 to 2060. The role of vitamin D in the prevention and treatment of diseases associated with aging has not been well studied. Traditionally, the role of vitamin D focused on the maintenance of skeletal health in the older adult. With the discovery of vitamin D receptors in the nervous, cardiovascular and endocrine systems, the role of vitamin D and its impact on these systems has become an important area of research. Older adults are at risk for lower levels of vitamin D as a result of decreased cutaneous synthesis and dietary intake of vitamin D. Epidemiologic evidence indicates an association between low levels of vitamin D and diseases associated with aging such as cognitive decline, depression, osteoporosis, cardiovascular disease, hypertension, type 2 diabetes, and cancer. Clinical trials to determine the benefit of vitamin D supplementation in preventing and treating such diseases are in progress. This paper highlights current evidence regarding the role that vitamin D may play in diseases associated with aging and addresses the need for well-designed randomized trials to examine its benefit on health outcomes in the older adult.
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Affiliation(s)
- Meghan Meehan
- School of Nursing, Loyola University Chicago, IL., USA
| | - Sue Penckofer
- School of Nursing, Loyola University Chicago, IL., USA
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Chei CL, Raman P, Yin ZX, Shi XM, Zeng Y, Matchar DB. Vitamin D levels and cognition in elderly adults in China. J Am Geriatr Soc 2014; 62:2125-9. [PMID: 25283584 DOI: 10.1111/jgs.13082] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate the association between vitamin D level and cognitive impairment in individuals aged 60 and older. DESIGN Cross-sectional cohort study. SETTING Chinese Longitudinal Healthy Longevity Survey, a community-based cohort study in areas in China where the density of centenarians is exceptionally high. PARTICIPANTS Individuals with mean age of 84.9 ± 12.7 (N = 2,004). MEASUREMENTS Participants' cognitive state was evaluated using the Mini-Mental State Examination (MMSE). Vitamin D was measured in plasma using an enzyme-linked immunoassay. RESULTS The cross-sectional association between quartiles of plasma vitamin D level and cognitive impairment (MMSE score <18) was modeled using logistic regressions. Plasma vitamin D levels were lower in individuals with cognitive impairment (31.9 ± 15.3 nmol/L) than in those without (45.6 ± 19.6 nmol/L). There was a reverse association between plasma vitamin D and cognitive impairment. After adjusting for age, sex, chronic conditions, smoking and drinking habits, outdoor activities, depression, and activity of daily living limitations, the association remained significant. The multivariable-adjusted odds ratio for lowest versus highest vitamin D levels was 2.15 (95% confidence interval (CI) = 1.05-4.41) for cognitive impairment, and the multivariable odds ratio associated with a 1-standard deviation decrement in plasma vitamin D was 1.32 (95% CI = 1.00-1.74) for cognitive impairment. CONCLUSION Low plasma vitamin D levels were associated with greater odds of cognitive impairment. Further prospective studies in Asian populations are needed to examine the causal direction of this association.
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Affiliation(s)
- Choy-Lye Chei
- Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore; Department of Public Health Medicines, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Littlejohns TJ, Henley WE, Lang IA, Annweiler C, Beauchet O, Chaves PHM, Fried L, Kestenbaum BR, Kuller LH, Langa KM, Lopez OL, Kos K, Soni M, Llewellyn DJ. Vitamin D and the risk of dementia and Alzheimer disease. Neurology 2014; 83:920-8. [PMID: 25098535 PMCID: PMC4153851 DOI: 10.1212/wnl.0000000000000755] [Citation(s) in RCA: 330] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 05/28/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To determine whether low vitamin D concentrations are associated with an increased risk of incident all-cause dementia and Alzheimer disease. METHODS One thousand six hundred fifty-eight elderly ambulatory adults free from dementia, cardiovascular disease, and stroke who participated in the US population-based Cardiovascular Health Study between 1992-1993 and 1999 were included. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by liquid chromatography-tandem mass spectrometry from blood samples collected in 1992-1993. Incident all-cause dementia and Alzheimer disease status were assessed during follow-up using National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria. RESULTS During a mean follow-up of 5.6 years, 171 participants developed all-cause dementia, including 102 cases of Alzheimer disease. Using Cox proportional hazards models, the multivariate adjusted hazard ratios (95% confidence interval [CI]) for incident all-cause dementia in participants who were severely 25(OH)D deficient (<25 nmol/L) and deficient (≥25 to <50 nmol/L) were 2.25 (95% CI: 1.23-4.13) and 1.53 (95% CI: 1.06-2.21) compared to participants with sufficient concentrations (≥50 nmol/L). The multivariate adjusted hazard ratios for incident Alzheimer disease in participants who were severely 25(OH)D deficient and deficient compared to participants with sufficient concentrations were 2.22 (95% CI: 1.02-4.83) and 1.69 (95% CI: 1.06-2.69). In multivariate adjusted penalized smoothing spline plots, the risk of all-cause dementia and Alzheimer disease markedly increased below a threshold of 50 nmol/L. CONCLUSION Our results confirm that vitamin D deficiency is associated with a substantially increased risk of all-cause dementia and Alzheimer disease. This adds to the ongoing debate about the role of vitamin D in nonskeletal conditions.
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Affiliation(s)
- Thomas J Littlejohns
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - William E Henley
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Iain A Lang
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Cedric Annweiler
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Olivier Beauchet
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Paulo H M Chaves
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Linda Fried
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Bryan R Kestenbaum
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Lewis H Kuller
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Kenneth M Langa
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Oscar L Lopez
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Katarina Kos
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - Maya Soni
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor
| | - David J Llewellyn
- From the University of Exeter Medical School (T.J.L., W.E.H., I.A.L., K.K., M.S., D.J.L.), Exeter, UK; Department of Internal Medicine and Geriatrics (C.A., O.B.), Angers University Hospital, Angers, France; Herbert Wertheim College of Medicine (P.H.M.C.), Florida International University, Miami; Mailman School of Public Health (L.F.), Columbia University, New York; Kidney Research Institute, Division of Nephrology (B.R.K.), University of Washington, Seattle; Departments of Epidemiology (L.H.K.) and Neurology and Psychiatry (O.L.L.), University of Pittsburgh, PA; Division of General Medicine (K.M.L.), Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI; and the Institute for Social Research and the Institute for Healthcare Policy and Innovation (K.M.L.), University of Michigan, Ann Arbor.
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Oude Voshaar RC, Derks WJ, Comijs HC, Schoevers RA, de Borst MH, Marijnissen RM. Antidepressants differentially related to 1,25-(OH)₂ vitamin D₃ and 25-(OH) vitamin D₃ in late-life depression. Transl Psychiatry 2014; 4:e383. [PMID: 24736799 PMCID: PMC4012279 DOI: 10.1038/tp.2014.14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 02/02/2014] [Indexed: 12/21/2022] Open
Abstract
A low plasma 25-OH vitamin D3 level is a universal risk factor for a wide range of diseases and has also been implicated in late-life depression. It is currently unknown whether the biologically active form of vitamin D, that is, 1,25-(OH)2 vitamin D3, is also decreased in late-life depression, or whether vitamin D levels correlate with specific depression characteristics. We determined plasma 25-OH vitamin D3, 1,25-(OH)2 vitamin D3 and parathormone levels in 355 depressed older persons and 124 non-depressed comparison subjects (age 60 years). Psychopathology was established with the Composite International Diagnostic Interview 2.1, together with potential confounders and depression characteristics (severity, symptom profile, age of onset, recurrence, chronicity and antidepressant drug use). Adjusted for confounders, depressed patients had significantly lower levels of 25-OH vitamin D33 (Cohen's d =0.28 (95% confidence interval: 0.07-0.49), P=0.033) as well as 1,25-(OH)2 vitamin D3 (Cohen's d =0.48 (95% confidence interval: 0.27-0.70), P<0.001) than comparison subjects. Of all depression characteristics tested, only the use of tricyclic antidepressants (TCAs) was significantly correlated with lower 1,25-(OH)2 vitamin D3 levels (Cohen's d =0.86 (95% confidence interval: 0.53-1.19), P<0.001), but not its often measured precursor 25-OH vitamin D3. As vitamin D levels were significantly lower after adjustment for confounders, vitamin D might have an aetiological role in late-life depression. Differences between depressed and non-depressed subjects were largest for the biologically active form of vitamin D. The differential impact of TCAs on 25-OH vitamin D3 and 1,25-(OH)2 vitamin D3 levels suggests modulation of 1-α-hydroxylase and/or 24-hydroxylase, which may in turn have clinical implications for biological ageing mechanisms in late-life depression.
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Affiliation(s)
- R C Oude Voshaar
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands
| | - W J Derks
- Pro Persona, Department of Old Age Psychiatry, Wolfheze/Arnhem, The Netherlands
| | - H C Comijs
- VU Medical Center, Department of Psychiatry and GGZinGeest, EMGO Institute of Health and Care Research, Amsterdam, The Netherlands
| | - R A Schoevers
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands
| | - M H de Borst
- University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Division of Nephrology, Groningen, The Netherlands
| | - R M Marijnissen
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, The Netherlands
- Pro Persona, Department of Old Age Psychiatry, Wolfheze/Arnhem, The Netherlands
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Kimlin MG, Lucas RM, Harrison SL, van der Mei I, Armstrong BK, Whiteman DC, Kricker A, Nowak M, Brodie AM, Sun J. The contributions of solar ultraviolet radiation exposure and other determinants to serum 25-hydroxyvitamin D concentrations in Australian adults: the AusD Study. Am J Epidemiol 2014; 179:864-74. [PMID: 24573539 DOI: 10.1093/aje/kwt446] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The Quantitative Assessment of Solar UV [ultraviolet] Exposure for Vitamin D Synthesis in Australian Adults (AusD) Study aimed to better define the relationship between sun exposure and serum 25-hydroxyvitamin D (25(OH)D) concentration. Cross-sectional data were collected between May 2009 and December 2010 from 1,002 participants aged 18-75 years in 4 Australian sites spanning 24° of latitude. Participants completed the following: 1) questionnaires on sun exposure, dietary vitamin D intake, and vitamin D supplementation; 2) 10 days of personal ultraviolet radiation dosimetry; 3) a sun exposure and physical activity diary; and 4) clinical measurements and blood collection for 25(OH)D determination. Our multiple regression model described 40% of the variance in 25(OH)D concentration; modifiable behavioral factors contributed 52% of the explained variance, and environmental and demographic or constitutional variables contributed 38% and 10%, respectively. The amount of skin exposed was the single strongest contributor to the explained variance (27%), followed by location (20%), season (17%), personal ultraviolet radiation exposure (8%), vitamin D supplementation (7%), body mass index (weight (kg)/height (m)(2)) (4%), and physical activity (4%). Modifiable behavioral factors strongly influence serum 25(OH)D concentrations in Australian adults. In addition, latitude was a strong determinant of the relative contribution of different behavioral factors.
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Mizwicki MT, Liu G, Fiala M, Magpantay L, Sayre J, Siani A, Mahanian M, Weitzman R, Hayden EY, Rosenthal MJ, Nemere I, Ringman J, Teplow DB. 1α,25-dihydroxyvitamin D3 and resolvin D1 retune the balance between amyloid-β phagocytosis and inflammation in Alzheimer's disease patients. J Alzheimers Dis 2013. [PMID: 23186989 DOI: 10.3233/jad-121735] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
As immune defects in amyloid-β (Aβ) phagocytosis and degradation underlie Aβ deposition and inflammation in Alzheimer's disease (AD) brain, better understanding of the relation between Aβ phagocytosis and inflammation could lead to promising preventive strategies. We tested two immune modulators in peripheral blood mononuclear cells (PBMCs) of AD patients and controls: 1α,25(OH)2-vitamin D3 (1,25D3) and resolvin D1 (RvD1). Both 1,25D3 and RvD1 improved phagocytosis of FAM-Aβ by AD macrophages and inhibited fibrillar Aβ-induced apoptosis. The action of 1,25D3 depended on the nuclear vitamin D and the protein disulfide isomerase A3 receptors, whereas RvD1 required the chemokine receptor, GPR32. The activities of 1,25D3 and RvD1 commonly required intracellular calcium, MEK1/2, PKA, and PI3K signaling; however, the effect of RvD1 was more sensitive to pertussis toxin. In this case study, the AD patients: a) showed significant transcriptional up regulation of IL1RN, ITGB2, and NFκB; and b) revealed two distinct groups when compared to controls: group 1 decreased and group 2 increased transcription of TLRs, IL-1, IL1R1 and chemokines. In the PBMCs/macrophages of both groups, soluble Aβ (sAβ) increased the transcription/secretion of cytokines (e.g., IL1 and IL6) and chemokines (e.g., CCLs and CXCLs) and 1,25D3/RvD1 reversed most of the sAβ effects. However, they both further increased the expression of IL1 in the group 1, sβ-treated cells. We conclude that in vitro, 1,25D3 and RvD1 rebalance inflammation to promote Aβ phagocytosis, and suggest that low vitamin D3 and docosahexaenoic acid intake and/or poor anabolic production of 1,25D3/RvD1 in PBMCs could contribute to AD onset/pathology.
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Affiliation(s)
- Mathew T Mizwicki
- Department of Surgery, David Geffen School of Medicine at UCLA, University of California-Los Angeles, CA 90095, USA.
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Gillette-Guyonnet S, Secher M, Vellas B. Nutrition and neurodegeneration: epidemiological evidence and challenges for future research. Br J Clin Pharmacol 2013; 75:738-55. [PMID: 23384081 DOI: 10.1111/bcp.12058] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 11/20/2012] [Indexed: 12/15/2022] Open
Abstract
The prevention of dementias, such as Alzheimer's disease (AD), is a growing public health concern, due to a lack of effective curative treatment options and a rising global prevalence. Various potential risk or preventive factors have been suggested by epidemiological research, including modifiable lifestyle factors such as diet. Current epidemiological data are in favour of a protective role of certain micronutrients (B vitamins related to homocysteine metabolism, the anti-oxidant vitamins C and E, flavonoids, polyunsatured omega-3 fatty acids, vitamin D) and macronutrients (fish) in the prevention of cognitive decline and dementia/AD. Some factors have been targeted by interventions tested in randomized controlled trials (RCTs), but many of the results are conflicting with observational evidence. Epidemiological analysis of the relations between nutrient consumption and cognitive decline is complex and it is highly unlikely that a single component plays a major role. In addition, since multiple factors across the life course influence brain function in late life, multidomain interventions might be more promising in the prevention of cognitive decline and dementia/AD. Designing such trials remains very challenging for researchers. The main objective of this paper is to review the epidemiologic data linking potential protective factors to cognitive decline or dementia/AD, focusing particularly on the roles of adiposity, caloric restriction, micro (group B vitamins related to homocysteine metabolism, the anti-oxidant vitamins C and E, flavonoids, polyunsatured omega-3 fatty acids, vitamin D) and macronutrients (fish). Limitations of the current data, divergence with results of interventional prevention studies and challenges for future research are discussed.
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Affiliation(s)
- Sophie Gillette-Guyonnet
- Gerontopole, Toulouse University Hospital, Department of Internal Medicine and Geriatrics, Purpan University Hospital, Toulouse F-31059, France.
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Sugawara N, Yasui-Furukori N, Umeda T, Tsuchimine S, Kaneda A, Tsuruga K, Iwane K, Okubo N, Takahashi I, Kaneko S. Relationship between dietary patterns and cognitive function in a community-dwelling population in Japan. Asia Pac J Public Health 2013; 27:NP2651-60. [PMID: 23858514 DOI: 10.1177/1010539513490194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to clarify the association between dietary patterns and cognitive function in a community-dwelling population in Japan. A total of 388 volunteers (60 years and older) who participated in the Iwaki Health Promotion Project 2011 were recruited. Diet was assessed with a validated, self-administered brief-type diet history questionnaire. Dietary patterns were extracted from 52 predefined food groups by principal component analysis. The Mini-Mental State Examination was also used to measure global cognitive status. Three dietary patterns were identified as follows: "Healthy," "Noodle," and "Alcohol and accompaniment." Compared with the low tertile of the "Alcohol and accompaniment" pattern, only the middle tertile was independently related to an increased risk of poor cognitive function. In conclusions, present study failed to substantiate dose-dependent associations between dietary patterns and the risk of poor cognitive function. Further studies with longitudinal observations are warranted.
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Affiliation(s)
| | | | - Takashi Umeda
- Hirosaki University School of Medicine, Hirosaki, Japan
| | | | - Ayako Kaneda
- Hirosaki University School of Medicine, Hirosaki, Japan
| | - Koji Tsuruga
- Hirosaki University School of Medicine, Hirosaki, Japan
| | - Kaori Iwane
- Hirosaki University School of Medicine, Hirosaki, Japan
| | | | | | - Sunao Kaneko
- Hirosaki University School of Medicine, Hirosaki, Japan
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Brouwer-Brolsma EM, Bischoff-Ferrari HA, Bouillon R, Feskens EJM, Gallagher CJ, Hypponen E, Llewellyn DJ, Stoecklin E, Dierkes J, Kies AK, Kok FJ, Lamberg-Allardt C, Moser U, Pilz S, Saris WH, van Schoor NM, Weber P, Witkamp R, Zittermann A, de Groot LCPGM. Vitamin D: do we get enough? A discussion between vitamin D experts in order to make a step towards the harmonisation of dietary reference intakes for vitamin D across Europe. Osteoporos Int 2013; 24:1567-77. [PMID: 23229471 DOI: 10.1007/s00198-012-2231-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 11/22/2012] [Indexed: 02/06/2023]
Abstract
UNLABELLED On September 29, 2011, acknowledged experts in the field of vitamin D, mainly European, were brought together in order to discuss the recent scientific advances in relation to vitamin D: the current requirements and associations with various health outcomes. In this article, the discussions resulting from the meeting are summarized. INTRODUCTION Several groups at risk for developing vitamin D insufficiency have been identified. Accordingly, reviews indicate that a significant percentage of the population worldwide have serum 25-hydroxyvitamin D levels below 50 nmol/l. In addition to the role of vitamin D in bone health, recent studies suggest that it may play a pivotal role in other systems, e.g., the cardiovascular system, pancreas, muscle, immune system and brain. Most evidence, however, is obtained from observational studies and yet inconclusive. METHODS To exchange and broaden knowledge on the requirements for vitamin D and its effect on various health outcomes, a workshop entitled "Vitamin D Expert Meeting: Do we get enough?", was organized. RESULTS Despite low vitamin D levels worldwide, consensus on the definition of deficiency is not yet reached. In order to define cut-off points for vitamin D whilst taking into account extraskeletal health effects, randomized controlled trials in these fields are warranted. The experts do emphasize that there is evidence to suggest an important role for vitamin D in the maintenance of optimal bone health at all ages and that vitamin D supplementation, in most studies co-administered with calcium, reduces fracture risk in the senior population. CONCLUSION To reach a serum 25-hydroxyvitamin D level of 50 nmol/l older adults aged ≥65 years are therefore recommended to meet a mean daily vitamin D intake of 20 μg (800 IU), which is best achieved with a supplement.
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Affiliation(s)
- E M Brouwer-Brolsma
- Division of Human Nutrition, Wageningen University and Research Centre, P.O. Box 8129, 6700, EV, Wageningen, The Netherlands.
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Effectiveness of the combination of memantine plus vitamin D on cognition in patients with Alzheimer disease: a pre-post pilot study. Cogn Behav Neurol 2013; 25:121-7. [PMID: 22960436 DOI: 10.1097/wnn.0b013e31826df647] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine whether treatment with memantine plus vitamin D is more effective than memantine or vitamin D alone in improving cognition among patients with Alzheimer disease (AD). METHODS We studied 43 white outpatients (mean 84.7 ± 6.3 years; 65.1% women) with a new diagnosis of AD, who had not taken anti-dementia drugs or vitamin D supplements. We prescribed memantine alone (n = 18), vitamin D alone (n = 17), or memantine plus vitamin D (n = 8) for an average of 6 months. We assessed cognitive change with the Mini-Mental State Examination (MMSE). We used age, sex, pre-treatment MMSE score, and duration of treatment as covariables. RESULTS Before treatment, the 3 groups had comparable MMSE scores. At 6 months, participants taking memantine plus vitamin D increased their MMSE score by 4.0 ± 3.7 points (P = 0.034), while participants taking memantine alone remained stable (change of 0.0 ± 1.8 points; P = 0.891), as did those taking vitamin D alone (-0.6 ± 3.1 points; P = 0.504). Treatment with memantine plus vitamin D was associated with improvement in the MMSE score compared to memantine or vitamin D alone after adjustment for covariables (P < 0.01). Mixed regression analysis showed that the visit by combined treatments (memantine plus vitamin D) interaction was significant (P = 0.001), while memantine or vitamin D alone showed no effect. CONCLUSIONS Patients with AD who took memantine plus vitamin D for 6 months had a statistically and clinically relevant gain in cognition, underlining possible synergistic and potentiating benefits of the combination.
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Nissou MF, Brocard J, El Atifi M, Guttin A, Andrieux A, Berger F, Issartel JP, Wion D. The transcriptomic response of mixed neuron-glial cell cultures to 1,25-dihydroxyvitamin d3 includes genes limiting the progression of neurodegenerative diseases. J Alzheimers Dis 2013; 35:553-64. [PMID: 23455988 PMCID: PMC3962683 DOI: 10.3233/jad-122005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Seasonal or chronic vitamin D deficiency and/or insufficiency is highly prevalent in the human population. Receptors for 1,25-dihydroxyvitamin D3, the hormonal metabolite of vitamin D, are found throughout the brain. To provide further information on the role of this hormone on brain function, we analyzed the transcriptomic profiles of mixed neuron-glial cell cultures in response to 1,25-dihydroxyvitamin D3. 1,25-dihydroxyvitamin D3 treatment increases the mRNA levels of 27 genes by at least 1.9 fold. Among them, 17 genes were related to neurodegenerative and psychiatric diseases, or brain morphogenesis. Notably, 10 of these genes encode proteins potentially limiting the progression of Alzheimer's disease. These data provide support for a role of 1,25-dihydroxyvitamin D3 in brain disease prevention. The possible consequences of circannual or chronic vitamin D insufficiencies on a tissue with a low regenerative potential such as the brain should be considered.
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Affiliation(s)
- Marie-France Nissou
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
| | - Jacques Brocard
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
| | - Michèle El Atifi
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
| | - Audrey Guttin
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
| | - Annie Andrieux
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
- GPC-GIN, Groupe Physiopathologie du Cytosquelette
INSERM : U836CEA : DSV/IRTSV/GPCUniversité Joseph Fourier - Grenoble IUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
| | - François Berger
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
| | - Jean-Paul Issartel
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
| | - Didier Wion
- GIN, Grenoble Institut des Neurosciences
INSERM : U836Université Joseph Fourier - Grenoble ICHU GrenobleCEA : DSV/IRTSVUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9, FR
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Annweiler C, Montero-Odasso M, Hachinski V, Seshadri S, Bartha R, Beauchet O. Vitamin D concentration and lateral cerebral ventricle volume in older adults. Mol Nutr Food Res 2012; 57:267-76. [PMID: 23281306 DOI: 10.1002/mnfr.201200418] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 09/28/2012] [Accepted: 10/16/2012] [Indexed: 12/24/2022]
Abstract
SCOPE Vitamin D deficiency is associated with an enlargement of the lateral cerebral ventricles in rodents. The effect of low serum 25-hydroxyvitamin D (25OHD) on lateral cerebral ventricle volume has not been studied yet in humans. The purpose of this cross-sectional study was to determine whether vitamin D deficiency was associated with greater lateral cerebral ventricle volume in older adults. METHODS AND RESULTS Ninety-two Caucasian community-dwellers with no clinical hydrocephalus (mean, 72.2 ± 6.2 years; 46.7% female) were divided into two groups according to serum 25OHD concentration (deficiency ≤ 50 nmol/L; normal > 50 nmol/L). Cerebral ventricular volume was quantified using semi-automated software from three-dimensional T1-weighted MRI. Age, gender, body mass index, blood pressure, education level, Mini-Mental State Examination, white matter lesions, and serum calcium concentrations were used as covariates. There was an inverse linear association between 25OHD concentration and ventricular volume (p = 0.049). Compared to individuals with normal 25OHD, those with 25OHD deficiency (n = 33) had 28% larger lateral ventricles (46.9 ± 26.8 mL versus 36.6 ± 16.4 mL, p = 0.026). Vitamin D deficiency was associated with an increase in ventricular volume (adjustedβ = 16.55, p = 0.023). The ventricular enlargement involved ventricle bodies (p = 0.025) but not temporal horns (p = 0.112). CONCLUSION Serum 25OHD deficiency was associated with larger lateral cerebral ventricles. These findings provide a scientific base for vitamin D replacement trials.
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Affiliation(s)
- Cédric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, University Memory Clinic of Angers, UPRES EA 4638, University of Angers, UNAM, Angers, France.
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