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Exploring the Association between Vitamin D and Changes in Cognitive Function in Chilean Older Adults: Evidence from the ALEXANDROS Cohort Study. J Pers Med 2022; 12:jpm12071078. [PMID: 35887574 PMCID: PMC9319397 DOI: 10.3390/jpm12071078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The increasing aging of the population with the consequent increase of age-associated cognitive disorders pose the challenge of controlling its preventable risk factors, among which vitamin D deficit is a putative factor. Thus, our objective is to explore the association between vitamin D and cognitive performance in a cohort study of community-dwelling Chilean older people. Material and Methods: Cohort study of 955 (69.7% female), community-dwelling older Chileans free of cognitive impairment from the Alexandros cohorts, with 25(OH)D measurement at baseline. Cognitive Function was evaluated with the Mini Mental State Examination (MMSE) short-form questionnaire. Plasma levels of 25(OH)D were classified as Normal > 30 ng/mL Insufficiency 20−29 ng/mL, Deficiency 20−12 ng/mL and Severe Deficiency < 12 ng/mL. Penalized regressions models were made to assess associations. Results: Mean age of the sample was 66.6 + 4.5 years, with 8.5 + 4.7 years of education. After a mean follow-up of 9.6 years, 54 new cases of Mild Cognitive Impairment (MCI)were identified (Incidence density rate = 5.9 per 1000 person/years). Mean vitamin D plasma levels were lower in people with MCI than in the normal cognitive ones (23.0 + 12.75 vs. 28.35 + 15.17 ng/mL, p < 0.01). In the fully adjusted model only severe deficiency of vitamin D was associated with MCI (RR = 2.33; 95% CI: (1.03−5.26). Conclusions: In this longitudinal study, our results confirm that low Vitamin D is a risk factor for MCI, and that people with severe deficiency have more than double the risk of MCI people with normal Vitamin D levels. Considering the high frequency of vitamin D deficiency in older people, and its preventability, these results are very valuable for future public health programmes.
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Arosio B, Rossi PD, Ferri E, Cesari M, Vitale G. Characterization of Vitamin D Status in Older Persons with Cognitive Impairment. Nutrients 2022; 14:nu14061142. [PMID: 35334800 PMCID: PMC8949190 DOI: 10.3390/nu14061142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 01/13/2023] Open
Abstract
Vitamin D exerts a role in the maintenance of cognitive abilities and in frailty. Although several studies evaluated the interactions between vitamin D and cognitive impairment, results were conflicting. In a cohort of community-dwelling older persons, we described the association between vitamin D levels and cognitive decline and all-cause dementia evaluating frailty’s contribution. Our cohort included 509 adults, aged 64–92 years: 176 patients with mild cognitive impairment (MCI), 59 with Alzheimer’s Disease (AD), 26 with idiopathic Normal Pressure Hydrocephalus (iNPH), 133 with mixed dementia (MD) and 115 without cognitive decline. Frailty was measured by frailty index, and serum 25-hydroxyvitamin D concentrations through electrochemiluminescence immunoassays. We found a significant association between vitamin D levels and Mini Mental State Examination independently of cognitive impairment, age, sex and frailty. The patients with dementia (AD and MD) showed the lowest vitamin D levels, while MCI patients showed higher levels than the other groups. The most severe deficiency was observed in MD patients, the most aged as well as cognitively and functionally impaired. In conclusion, in our community-dwelling older persons investigated for a suspected cognitive impairment, we observed an association between vitamin D levels and cognitive decline, regardless of the frailty status.
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Affiliation(s)
- Beatrice Arosio
- Department of Clinical Sciences and Community Health, University of Milan, Via Pace 9, 20122 Milan, Italy;
- Correspondence: ; Tel.: +39-02-55035405; Fax: +39-02-50320734
| | - Paolo Dionigi Rossi
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy; (P.D.R.); (E.F.)
| | - Evelyn Ferri
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy; (P.D.R.); (E.F.)
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Via Pace 9, 20122 Milan, Italy;
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138 Milan, Italy
| | - Giovanni Vitale
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Via Vanvitelli 32, 20133 Milan, Italy;
- Istituto Auxologico Italiano IRCCS, Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Via Zucchi 18, 20095 Cusano Milanino, Italy
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Serum Vitamin D as a Biomarker in Autoimmune, Psychiatric and Neurodegenerative Diseases. Diagnostics (Basel) 2022; 12:diagnostics12010130. [PMID: 35054296 PMCID: PMC8774449 DOI: 10.3390/diagnostics12010130] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 02/05/2023] Open
Abstract
Vitamin D is a steroid hormone regulating calcium-phosphorus homeostasis, immune response and brain function. In the past thirty years, an increasing number of cohort studies, meta-analyses and randomized controlled trials (RTCs) evaluated the serum levels of 25-hydroxyvitamin D [25(OH)D], which is considered the Vitamin D status biomarker, in patients affected by neurological, psychiatric and autoimmune diseases. Although an association between low 25(OH)D serum levels and the prevalence of these diseases has been found, it is still unclear whether the serum 25(OH)D measurement can be clinically useful as a biomarker for diagnosis, prognosis and predicting treatment response in neurodegeneration, mental illness and immune-mediated disorders. The lack of standardized data, as well as discrepancies among the studies (in the analytical methods, cut-offs, endpoints and study sets), weakened the findings achieved, hindered pooling data, and, consequently, hampered drawing conclusions. This narrative review summarizes the main findings from the studies performed on serum 25(OH)D in neurological, psychiatric and autoimmune diseases, and clarifies whether or not serum 25(OH)D can be used as a reliable biomarker in these diseases.
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Bivona G, Lo Sasso B, Gambino CM, Giglio RV, Scazzone C, Agnello L, Ciaccio M. The Role of Vitamin D as a Biomarker in Alzheimer's Disease. Brain Sci 2021; 11:brainsci11030334. [PMID: 33800891 PMCID: PMC8000099 DOI: 10.3390/brainsci11030334] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 01/01/2023] Open
Abstract
Vitamin D and cognition is a popular association, which led to a remarkable body of literature data in the past 50 years. The brain can synthesize, catabolize, and receive Vitamin D, which has been proved to regulate many cellular processes in neurons and microglia. Vitamin D helps synaptic plasticity and neurotransmission in dopaminergic neural circuits and exerts anti-inflammatory and neuroprotective activities within the brain by reducing the synthesis of pro-inflammatory cytokines and the oxidative stress load. Further, Vitamin D action in the brain has been related to the clearance of amyloid plaques, which represent a feature of Alzheimer Disease (AD), by the immune cell. Based on these considerations, many studies have investigated the role of circulating Vitamin D levels in patients affected by a cognitive decline to assess Vitamin D’s eventual role as a biomarker or a risk factor in AD. An association between low Vitamin D levels and the onset and progression of AD has been reported, and some interventional studies to evaluate the role of Vitamin D in preventing AD onset have been performed. However, many pitfalls affected the studies available, including substantial discrepancies in the methods used and the lack of standardized data. Despite many studies, it remains unclear whether Vitamin D can have a role in cognitive decline and AD. This narrative review aims to answer two key questions: whether Vitamin D can be used as a reliable tool for diagnosing, predicting prognosis and response to treatment in AD patients, and whether it is a modifiable risk factor for preventing AD onset.
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Affiliation(s)
- Giulia Bivona
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Bruna Lo Sasso
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
- Department of Laboratory Medicine, AOUP “P. Giaccone”, 90127 Palermo, Italy
| | - Caterina Maria Gambino
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Rosaria Vincenza Giglio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Concetta Scazzone
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Luisa Agnello
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
| | - Marcello Ciaccio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (G.B.); (B.L.S.); (C.M.G.); (R.V.G.); (C.S.); (L.A.)
- Department of Laboratory Medicine, AOUP “P. Giaccone”, 90127 Palermo, Italy
- Correspondence:
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Mielech A, Puścion-Jakubik A, Markiewicz-Żukowska R, Socha K. Vitamins in Alzheimer's Disease-Review of the Latest Reports. Nutrients 2020; 12:nu12113458. [PMID: 33187212 PMCID: PMC7696081 DOI: 10.3390/nu12113458] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 12/11/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia, and the aging of the population means that the number of cases is successively increasing. The cause of the disease has not been established, but it is suggested that many factors affect it, including nutritional aspects. As part of the work, the PubMed database has been searched, beginning from 2005, for terms related to key nutritional aspects. A diet rich in antioxidant vitamins can improve the cognitive functions of patients. Thanks to an adequate intake of B vitamins, homocysteine levels are reduced, which indirectly protects against the development of the disease. A properly balanced diet, as well as the use of appropriate supplementation, can contribute to improving the clinical condition of patients with AD.
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