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Cross-sectional and longitudinal associations between serum 25-hydroxyvitamin D and cognitive functioning

Published online by Cambridge University Press:  22 December 2015

N. M. van Schoor ,
H. C. Comijs ,
D. J. Llewellyn  and
P. Lips
N. M. van Schoor*
Affiliation:
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
H. C. Comijs
Affiliation:
Department Psychiatry/GGZinGeest, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
D. J. Llewellyn
Affiliation:
Medical School, University of Exeter, Exeter, UK
P. Lips
Affiliation:
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands Department of Internal Medicine, Endocrine Section, VU University Medical Center, Amsterdam, the Netherlands
*
Correspondence should be addressed to: N. M. van Schoor, VU University Medical Center, Department of Epidemiology and Biostatistics (LASA), F-vleugel Medical Faculty, Postbus 7057, 1007 MB Amsterdam, the Netherlands. Phone: +31-20-4448439; Fax: +31-20-4448171. Email: nm.vanschoor@vumc.nl.
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Abstract

Background:

Vitamin D deficiency is common in older persons. The objectives of this study were: To examine the cross-sectional and longitudinal association between serum 25-hydroxyvitamin D (25(OH)D) and cognitive functioning in older persons; and to explore the optimal cut-off for serum 25(OH)D.

Methods:

Data of the Longitudinal Aging Study Amsterdam (LASA) were used. Serum 25(OH)D was determined using a competitive protein binding assay in 1995/6 (n = 1,320). Cognitive functioning was assessed in 1995/6 and 1998/9 using the Mini-Mental State Examination (MMSE, general cognitive functioning), Raven's Colored Progressive Matrices (RCPM, ability of nonverbal and abstract reasoning), the Coding Task (CT, information processing speed), and the 15 Words Test (15WT, immediate memory and delayed recall). The data were analyzed using linear regression analyses and restricted cubic spline functions. The MMSE was normalized using ln(31-MMSE).

Results:

Mean serum 25(OH)D was 53.7 nmol/L. After adjustment for confounding, patients with serum 25(OH)D levels below 30 nmol/L had significantly lower general cognitive functioning (beta of ln(31-MMSE) = 0.122; p = 0.046) and slower information processing speed (beta = −2.177, p = 0.001) as compared with patients having serum 25(OH)D levels ≥ 75 nmol/L in the cross-sectional analyses. For both outcomes, the optimal cut-off was about 60 nmol/L. No other significant associations were observed.

Conclusions:

A lower serum 25(OH)D was significantly associated with lower general cognitive functioning and slower information processing speed, but not with a faster rate of cognitive decline.

Keywords

cognitive impairmentvitaminsaging
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 5 , May 2016 , pp. 759 - 768
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Annweiler, C., Rolland, Y., Schott, A. M., Blain, H., Vellas, B. and Beauchet, O. (2011). Serum vitamin D deficiency as a predictor of incident non-Alzheimer dementias: a 7-year longitudinal study. Dementia and Geriatric Cognitive Disorders, 32, 273–278.Google Scholar
Balion, C. et al. (2012). Vitamin D, cognition, and dementia: a systematic review and meta-analysis. Neurology, 79, 1397–1405.Google Scholar
Bouillon, R. et al. (2008). Vitamin D and human health: lessons from vitamin D receptor null mice. Endocrine Reviews., 29, 726–776.Google Scholar
Breitling, L. P., Perna, L., Muller, H., Raum, E., Kliegel, M. and Brenner, H. (2012). Vitamin D and cognitive functioning in the elderly population in Germany. Experimental Gerontology, 47, 122–127.Google Scholar
Burne, T. H., McGrath, J. J., Eyles, D. W. and Mackay-Sim, A. (2005). Behavioural characterization of vitamin D receptor knockout mice. Behavioural Brain Research, 157, 299–308.CrossRefGoogle ScholarPubMed
Egan, B. M. and Zhao, Y. (2013). Different definitions of prevalent hypertension impact: the clinical epidemiology of hypertension and attainment of healthy people goals. The Journal of Clinical Hypertension (Greenwich.), 15, 154–161.Google Scholar
Eyles, D. W., Smith, S., Kinobe, R., Hewison, M. and McGrath, J. J. (2005). Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. Journal of Chemical Neuroanatomy, 29, 21–30.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-mental state: a practical method for the clinician. Journal of Psychiatric Research, 12, 189–98.CrossRefGoogle Scholar
Gallagher, J. C., Sai, A., Templin, T. and Smith, L. (2012). Dose response to vitamin D supplementation in postmenopausal women: a randomized trial. Annals of Internal Medicine, 156, 425–437.Google Scholar
Garretsen HFL (1983). Probleemdrinken, prevalentiebepaling, beinvloedende factoren en preventiemogelijkheden, Theoretische overwegingen en onderzoek in Rotterdam (Dutch).Google Scholar
Groves, N. J., McGrath, J. J. and Burne, T. H. (2014). Vitamin D as a neurosteroid affecting the developing and adult brain. Annual Review of Nutrition, 34, 117–141.Google Scholar
Holick, M. F. et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 96, 1911–1930.Google Scholar
Huisman, M. et al. (2011). Cohort profile: the Longitudinal aging study Amsterdam. International Journal of Epidemiology, 40, 868–876.Google Scholar
Kalueff, A. V., Lou, Y. R., Laaksi, I. and Tuohimaa, P. (2004a). Increased anxiety in mice lacking vitamin D receptor gene. Neuroreport, 15, 1271–1274.Google Scholar
Kalueff, A. V., Lou, Y. R., Laaksi, I. and Tuohimaa, P. (2004b). Increased grooming behavior in mice lacking vitamin D receptors. Physiology & Behavior, 82, 405–409.CrossRefGoogle ScholarPubMed
Lips, P. (2001). Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocrine Reviews, 22, 477–501.Google Scholar
Llewellyn, D. J., Lang, I. A., Langa, K. M. and Melzer, D. (2011). Vitamin D and cognitive impairment in the elderly U.S. population. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 66, 59–65.Google Scholar
Llewellyn, D. J. et al. (2010). Vitamin D and risk of cognitive decline in elderly persons. Archives of Internal Medicine, 170, 1135–1141.CrossRefGoogle ScholarPubMed
Perna, L., Mons, U., Kliegel, M. and Brenner, H. (2014). Serum 25-hydroxyvitamin D and cognitive decline: a longitudinal study among non-demented older adults. Dementia and Geriatric Cognitive Disorders, 38, 254–263.Google Scholar
Puts, M. T., Visser, M., Twisk, J. W., Deeg, D. J. and Lips, P. (2005). Endocrine and inflammatory markers as predictors of frailty. Clinical Endocrinology (Oxford), 63, 403–411.Google Scholar
Raven, J. C. (1995). Manual for the Coloured Progressive Matrices (revised). Windsor, UK: NFRE-Nelson.Google Scholar
Rey, A. (1964). L’examen Clinique en Psychologie. Paris: Presse universitaire de France.Google Scholar
Ross, A. C. et al. (2011). The 2011 report on dietary reference intakes for calcium and vitamin D from the institute of medicine: what clinicians need to know. Journal of Clinical Endocrinology & Metabolism, 96, 53–58.CrossRefGoogle ScholarPubMed
Rossom, R. C. et al. (2012). Calcium and vitamin D supplementation and cognitive impairment in the women's health initiative. Journal of the American Geriatrics Society, 60, 2197–2205.Google Scholar
Savage, R. D. (1984). Alphabet Coding Task 15. Western Australia: Murdoch University.Google Scholar
Slinin, Y. et al. (2010). 25-Hydroxyvitamin D levels and cognitive performance and decline in elderly men. Neurology, 74, 33–41.Google Scholar
Slinin, Y. et al. (2012). Association between serum 25(OH) vitamin D and the risk of cognitive decline in older women. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 67, 1092–1098.CrossRefGoogle ScholarPubMed
Smits, C. H. M., Smit, J. H., van den Heuvel, N. and Jonker, C. (1997). Norms for an abbreviated Raven's coloured progressive matrices in an older sample. Journal of Clinical Psychology, 53, 687–697.Google Scholar
Stel, V. S., Smit, J. H., Pluijm, S. M. F., Visser, M., Deeg, D. J. H. and Lips, P. (2004). Comparison of the LASA physical activity questionnaire with a 7-day diary and pedometer. Journal of Clinical Epidemiology, 57, 252–258.Google Scholar
van den Heuvel, N. and Smits, C. H. M. (1994). Intelligence: raven's coloured progressive matrices. In Deeg, D. J. H. and Westendorp-de Seriere, M. (eds.), Autonomy and Well-Being in the Aging Population I: Report from the Longitudinal Aging Study Amsterdam 1992–1993. (pp. 53–58). Amsterdam: VU University Press.Google Scholar
van der Schaft, J., Koek, H. L., Dijkstra, E., Verhaar, H. J., van der Schouw, Y. T. and Emmelot-Vonk, M. H. (2013). The association between vitamin D and cognition: a systematic review. Ageing Research Reviews, 12, 1013–1023.CrossRefGoogle ScholarPubMed
Zehnder, D. et al. (2001). Extrarenal expression of 25-hydroxyvitamin d(3)-1 alpha-hydroxylase. Journal of Clinical Endocrinology & Metabolism, 86, 888–894.Google Scholar