Serum Vitamin D3 Concentration, Sleep, and Cognitive Impairment among Older Adults in China

Surveillance and Evaluation of Vitamin D Nutrition and Its Health Impact in Chinese Older Adults

Vitamin D is an essential fat-soluble vitamin for humans and vitamin D deficiency (VDD) affects all age groups, with older adults being at high risk of VDD. A deficiency in vitamin D has been associated with a range of health concerns in older adults, including osteomalacia and osteoporosis. Additionally, there is limited evidence suggesting that VDD may be associated with increased risk of developing cognitive impairment, muscle-wasting disorders, cardiovascular disease, type 2 diabetes mellitus, and mortality. This review synthesizes the latest research advances in China and abroad to provide detailed information on the current status of vitamin D nutritional monitoring, causes of deficiency, health risks, and proposed intake for reducing risk of diet-related noncommunicable diseases in the Chinese older adults.

Multiple sclerosis in china: the current state of diagnosis and management

PURPOSE OF REVIEW

This comprehensive overview summarized the latest advances of multiple sclerosis (MS) in China, including the diagnostic and treatment challenges, research and future directions under health policy recommendations.

RECENT FINDINGS

Given the rising prevalence of MS in China during the past decades, it has emerged as a significant public health concern due to the extensive population and pronounced disparities between urban and rural areas. The clinical manifestations of MS patients in China can be various due to the nation's diversity and evolving environmental factors. Advances in diagnostic practices, including the advances under 7T MRI radiological assessments, have enhanced the precision of MS diagnosis. Despite the introduction of disease-modifying therapeutic agents and the support of healthcare policies offering patients a wider range of treatment options, multiple ongoing research efforts and clinical trials will provide additional evidence. The ongoing China National Registry of Neuro-Inflammatory Diseases study (NCT05154370) holds promise for further enhancing the management of MS patients in China.

SUMMARY

Improved recognition and management of MS in China have been facilitated, encompassing both prompt diagnosis and diverse treatment options. Simultaneously, research efforts and large-scale cohort studies have significantly advanced the overall status in this field.

A Linkage Between 25-Hydroxyvitamin D and Post-Stroke Cognitive Impairment, as Well as the Duration of Hospitalization After a Stroke

AIMS

A variety of complications can arise following a stroke, with post-stroke cognitive impairment (PSCI) being a prevalent consequence. The objective of the research was to explore the relationship between 25(OH)D levels, PSCI, and the duration of hospitalization.

METHODS

Serum concentrations of 25(OH)D were measured within the first 24 h of hospital admission. Cognitive impairment in stroke patients was assessed using the Mini-Mental State Examination (MMSE). Functional independence was evaluated on the day of discharge using the Barthel Index (BI). Additionally, the duration of hospitalization for each patient was recorded. Data analysis was performed using SPSS statistical software.

RESULTS

An observation revealed that levels of 25(OH)D were comparatively reduced in stroke people who suffered from cognitive impairment as opposed to individuals without such impairment (p = 0.022). Patients with cognitive impairment following a stroke demonstrated reduced BI scores (p < 0.001) and longer durations of hospitalization (p = 0.002) in contrast to patients without cognitive impairment. Upon comparing groups with different concentrations of 25(OH)D, it was observed that individuals with low concentrations had longer hospitalization durations (p = 0.03) and higher NIHSS scores (p = 0.003) than those with high concentrations of 25(OH)D. Furthermore, binary logistic regression analysis indicated that a 25(OH)D level of < 25 nmol/L was a significant risk factor for cognitive impairment following a stroke.

CONCLUSIONS

The study indicated a potential linkage between reduced levels of 25(OH)D and an escalated susceptibility to cognitive impairment following a stroke. Furthermore, individuals with lower concentrations of 25(OH)D generally experienced longer hospital stays.

Association between sleep quality and cognitive impairment in older adults hypertensive patients in China: a case-control study

Background

Previous studies have found that poor sleep quality promotes the occurrence of cognitive impairment (CI), but this relationship has been rarely reported in older adults hypertensive patients. The purpose of this study was to investigate the relationship between sleep quality and CI in older adults hypertensive patients and the mediating effect of sleep quality between physical activity (PA) and CI.

Methods

A total of 2072 older adults hypertensive patients were included in this case-control study. Five hundred and eighteen older adults hypertensive patients with CI were matched 1:3 by age and sex to 1,554 older adults hypertensive patients with normal cognitive function. The International Physical Activity Questionnaire-Long Form, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination were used to evaluate PA intensity, sleep quality, and cognitive function in older adults hypertensive patients. Multivariate logistic regression and the mediation package in R Language were used to analyze the relationship between sleep quality and CI and the mediating effect of sleep quality between PA intensity and CI in older adults hypertensive patients.

Results

After adjusting for all confounding factors, sleep quality was positively correlated with CI in older adults hypertensive patients (OR = 2.565, 95%CI: 1.958-3.360, p < 0.001), and this relationship also existed in the older adults hypertensive patients with education levels of primary school and below and junior high school and above (OR = 2.468, 95%CI: 1.754-3.473, p < 0.001; OR = 2.385, 95%CI: 1.367-4.161, p = 0.002). In addition, sleep quality mediated part of the mediating effect between PA intensity and CI in older adults hypertensive patients (Za*Zb: - 17.19339; 95%CI: -0.37312, -0.04194).

Conclusion

Poor sleep quality was associated with the occurrence of CI in older adults hypertensive patients, and this relationship also existed in older adults hypertensive patients with education levels of primary school and below and junior high school and above.

1,25(OH)2D3 supplementation alleviates gut-vascular barrier disruption via inhibition of S100B/ADAM10 pathway

Gut-vascular barrier (GVB) is the second barrier in mucosa to control systemic dissemination of gut bacteria. Severe burns induce enteroglial cells to produce S100B and endothelial cells to generate ADAM10 and cause vitamin D3 insufficiency/deficiency and GVB disruption. It is not clear whether vitamin D3 supplementation attenuates GVB damage via regulation of S100B/ADAM10 pathway. Here, GVB disruption was induced by 30% of total body surface area scalds. Rats were treated with 1,25(OH)2D3 (0.05, 0.5 or 5 μg/kg) or S100B monoclonal antibody (S100BmAb, 10 μg/kg) or GI254023X (ADAM10 inhibitor, 100 mg/kg). Rat enteric glial cell-line CRL2690 and rat intestinal microvascular endothelial cells (RIMECs) were treated with S100B (5 μM) or plus 1,25(OH)2D3 (0.05, 0.5 or 5 μM) or GI254023X (5 μM). S100B, TNF-α, 25(OH)D3 and 1,25(OH)2D3 in serum and gut mucosa were determined by enzyme-linked immunosorbent assay. The endothelial permeability was measured using FITC-dextran 70 kDa. ADAM10 and β-catenin expression was assayed by Western blot. The results showed that 1,25(OH)2D3 and 25(OH)D3 concentration in serum reduced whereas TNF-α and S100B in serum and gut mucosa increased in burned rats. S100BmAb, GI254023X and 1,25(OH)2D3 treatment lowered burns-increased GVB permeability. 1,25(OH)2D3 also decreased S100B concentration in serum and gut mucosa. 1,25(OH)2D3 inhibited S100B release from TNF-α-treated CRL2690 and raised β-catenin while decreasing ADAM10 protein in S100B-treated RIMECs. 1,25(OH)2D3 and GI254023X also decreased the endothelial permeability of S100B-treated RIMECs. Collectively, these findings provide evidence that severe burns lower serum 25(OH)D3 and 1,25(OH)2D3 concentration. 1,25(OH)2D3 supplementation alleviates burns-elicited GVB disruption via inhibition of S100B/ADAM10 signaling.

Nutritional Status and Physical Exercise Are Associated with Cognitive Function in Chinese Community-Dwelling Older Adults: The Role of Happiness

We aim to assess the relationship between nutrition status, physical exercise, and cognitive function and particularly examine how happiness modifies and mediates the relationship, among 699 seniors aged 60 and above in Shanghai, China. Linear regression models were used to validate the effects of nutrition and exercise on cognitive function and to test their interaction effects with happiness. When the interactions were significant, stratified analyses in sub-groups were conducted. Mediation effects of happiness were examined using two-step causal mediation models. We confirmed that better nutrition (p < 0.001) and exercise (p = 0.009) were significantly associated with less cognitive decline. Furthermore, the effects of nutrition and exercise on cognitive decline were significant in the unhappy (happiness < 20) (p < 0.001) and younger (age < 74) sub-groups (p = 0.015). Happiness partially mediated 11.5% of the negative association of cognitive decline with nutrition (p = 0.015) and 23.0% of that with exercise (p = 0.017). This study suggests that happiness moderates and partially mediates the effects of exercise and nutrition on cognitive status. The beneficial effects of exercise and nutrition were stronger in less happy or younger seniors. Future intervention studies are required to confirm this path relationship.