Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Research Article

The Association between Vitamin D Deficiency and Changes in Cognitive Functions in Chinese Older Adults: A Prospective Cohort Study

Author(s): Tongtong Li, Chong Chen, Jing Yuan, Keming Zhang, Meilin Zhang, Huichao Zhao, Xiaomin Wu, Liping Zhu, Guowei Huang and Fei Ma*

Volume 20, Issue 7, 2023

Published on: 10 November, 2023

Page: [506 - 514] Pages: 9

DOI: 10.2174/0115672050266769231025060359

Price: $65

Abstract

Background: Along with the problem of population aging, the prevalence of dementia is gradually increasing. Associations between vitamin D deficiency (VDD) and cognitive functions remain unclear.

Objectives: We aimed to determine the relationship between VDD and changes in cognitive performance in community-dwelling older adults.

Methods: In this longitudinal cohort study, participants aged ≥65 years were enrolled in March, 2016. The serum level of 25-hydroxy-vitamin D was analyzed by liquid-chromatography-tandem-- mass-spectrometry at baseline. VDD was defined as less than 20 ng/mL. All participants completed a health status questionnaire. Cognitive functions were evaluated by the Wechsler Adult Intelligence Scale-Revised in China at baseline and each visit. The linear mixed-effects model was utilized to examine the association between baseline VDD and changes in cognitive functions.

Results: In total, 866 participants were included in our study, with a mean duration of 3 years. VDD was markedly associated with lower full intelligence quotient (FIQ) (β: -3.355, 95% confidence interval [CI]:-4.165,-2.545), verbal intelligence quotient (VIQ) (β: -3.420, 95%CI: -4.193,-2.647), performance intelligence quotient (PIQ) (β: -2.610, 95%CI: -3.683,-1.537), comprehension (β: -0.630, 95%CI: -1.022,-0.238), information (β: -0.354, 95%CI: -0.699,-0.008), arithmetic (β: -1.065, 95%CI: -1.228,-0.902), digit span (β: -0.370, 95%CI: -0.547,-0.192), vocabulary (β: -0.789, 95%CI: -1.084,-0.493), picture completion (β: -0.391, 95%CI: -0.761,-0.022), block design (β: -0.412, 95%CI: -0.697,-0.127), picture arrangement (β: -0.542, 95%CI: -0.909,-0.174), and object assembly (β: -0.492, 95%CI: -0.818,-0.165) than those with adequacy.

Conclusion: A higher frequency of VDD was associated with lower scores of FIQ, VIQ, PIQ and subtests on memory and executive function. Future randomized controlled trials are warranted to further verify the conclusions.

[1]
Winblad, B.; Amouyel, P.; Andrieu, S.; Ballard, C.; Brayne, C.; Brodaty, H.; Cedazo-Minguez, A.; Dubois, B.; Edvardsson, D.; Feldman, H.; Fratiglioni, L.; Frisoni, G.B.; Gauthier, S.; Georges, J.; Graff, C.; Iqbal, K.; Jessen, F.; Johansson, G.; Jönsson, L.; Kivipelto, M.; Knapp, M.; Mangialasche, F.; Melis, R.; Nordberg, A.; Rikkert, M.O.; Qiu, C.; Sakmar, T.P.; Scheltens, P.; Schneider, L.S.; Sperling, R.; Tjernberg, L.O.; Waldemar, G.; Wimo, A.; Zetterberg, H. Defeating Alzheimer’s disease and other dementias: A priority for European science and society. Lancet Neurol., 2016, 15(5), 455-532.
[http://dx.doi.org/10.1016/S1474-4422(16)00062-4] [PMID: 26987701]
[2]
Jia, J.; Hu, J.; Huo, X.; Miao, R.; Zhang, Y.; Ma, F. Effects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer’s disease: a randomised, double-blind, placebo-controlled trial. J. Neurol. Neurosurg. Psychiatry, 2019, 90(12)jnnp-2018-320199
[http://dx.doi.org/10.1136/jnnp-2018-320199] [PMID: 31296588]
[3]
Bai, D.; Fan, J.; Li, M.; Dong, C.; Gao, Y.; Fu, M.; Huang, G.; Liu, H. RETRACTED: Effects of folic acid combined with DHA supplementation on cognitive function and amyloid-β-related biomarkers in older adults with mild cognitive impairment by a randomized, double blind, placebo-controlled trial. J. Alzheimers Dis., 2021, 81(1), 155-167.
[http://dx.doi.org/10.3233/JAD-200997] [PMID: 33749643]
[4]
Hahn, J; Cook, NR; Alexander, EK Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial. BMJ, 2022, 376e066452.
[http://dx.doi.org/10.1136/bmj-2021-066452]
[5]
Manson, J.E.; Cook, N.R.; Lee, I.M.; Christen, W.; Bassuk, S.S.; Mora, S.; Gibson, H.; Gordon, D.; Copeland, T.; D’Agostino, D.; Friedenberg, G.; Ridge, C.; Bubes, V.; Giovannucci, E.L.; Willett, W.C.; Buring, J.E. Vitamin D supplements and prevention of cancer and cardiovascular disease. N. Engl. J. Med., 2019, 380(1), 33-44.
[http://dx.doi.org/10.1056/NEJMoa1809944] [PMID: 30415629]
[6]
Zhou, Z.; Zhou, R.; Zhang, Z.; Li, K. The association between vitamin D status, vitamin D supplementation, sunlight exposure, and parkinson’s disease: A systematic review and meta-analysis. Med. Sci. Monit., 2019, 25, 666-674.
[http://dx.doi.org/10.12659/MSM.912840] [PMID: 30672512]
[7]
Jorde, R.; Mathiesen, E.B.; Rogne, S.; Wilsgaard, T.; Kjærgaard, M.; Grimnes, G.; Schirmer, H. Vitamin D and cognitive function: The Tromsø Study. J. Neurol. Sci., 2015, 355(1-2), 155-161.
[http://dx.doi.org/10.1016/j.jns.2015.06.009] [PMID: 26092373]
[8]
Annweiler, C.; Fantino, B.; Schott, A.M.; Krolak-Salmon, P.; Allali, G.; Beauchet, O. Vitamin D insufficiency and mild cognitive impairment: cross-sectional association. Eur. J. Neurol., 2012, 19(7), 1023-1029.
[http://dx.doi.org/10.1111/j.1468-1331.2012.03675.x] [PMID: 22339714]
[9]
Llewellyn, D.J.; Lang, I.A.; Langa, K.M.; Melzer, D. Vitamin D and cognitive impairment in the elderly U.S. population. J. Gerontol. A Biol. Sci. Med. Sci., 2011, 66A(1), 59-65.
[http://dx.doi.org/10.1093/gerona/glq185] [PMID: 21041201]
[10]
Eyles, D.W.; Smith, S.; Kinobe, R.; Hewison, M.; McGrath, J.J. Distribution of the Vitamin D receptor and 1α-hydroxylase in human brain. J. Chem. Neuroanat., 2005, 29(1), 21-30.
[http://dx.doi.org/10.1016/j.jchemneu.2004.08.006] [PMID: 15589699]
[11]
Eyles, D.W.; Liu, P.Y.; Josh, P.; Cui, X. Intracellular distribution of the vitamin D receptor in the brain: Comparison with classic target tissues and redistribution with development. Neuroscience, 2014, 268, 1-9.
[http://dx.doi.org/10.1016/j.neuroscience.2014.02.042] [PMID: 24607320]
[12]
Holick, M.F. Vitamin D and brain health: the need for vitamin D supplementation and sensible sun exposure. J. Intern. Med., 2015, 277(1), 90-93.
[http://dx.doi.org/10.1111/joim.12308] [PMID: 25228442]
[13]
Dawson-Hughes, B.; Mithal, A.; Bonjour, J.P.; Boonen, S.; Burckhardt, P.; Fuleihan, G.E.H.; Josse, R.G.; Lips, P.; Morales-Torres, J.; Yoshimura, N. IOF position statement: Vitamin D recommendations for older adults. Osteoporos. Int., 2010, 21(7), 1151-1154.
[http://dx.doi.org/10.1007/s00198-010-1285-3] [PMID: 20422154]
[14]
Jorde, R.; Grimnes, G. Vitamin D and health: The need for more randomized controlled trials. J. Steroid Biochem. Mol. Biol., 2015, 148, 269-274.
[http://dx.doi.org/10.1016/j.jsbmb.2015.01.021] [PMID: 25636723]
[15]
Pavlovic, A.; Abel, K.; Barlow, C.E.; Farrell, S.W.; Weiner, M.; DeFina, L.F. The association between serum vitamin D level and cognitive function in older adults: Cooper Center Longitudinal Study. Prev. Med., 2018, 113, 57-61.
[http://dx.doi.org/10.1016/j.ypmed.2018.05.010] [PMID: 29753804]
[16]
Olsson, E.; Byberg, L.; Karlström, B.; Cederholm, T.; Melhus, H.; Sjögren, P.; Kilander, L. Vitamin D is not associated with incident dementia or cognitive impairment: an 18-y follow-up study in community-living old men. Am. J. Clin. Nutr., 2017, 105(4), 936-943.
[http://dx.doi.org/10.3945/ajcn.116.141531] [PMID: 28202477]
[17]
Márquez, C.; Angel, B.; Lera, L.; Bendayan, R.; Sánchez, H.; Albala, C. 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(7), 1078.
[http://dx.doi.org/10.3390/jpm12071078] [PMID: 35887574]
[18]
Palacios, N.; Scott, T.; Sahasrabudhe, N.; Gao, X.; Tucker, K.L. Serum vitamin D and cognition in a cohort of Boston-area Puerto Ricans. Nutr. Neurosci., 2020, 23(9), 688-695.
[http://dx.doi.org/10.1080/1028415X.2018.1545291] [PMID: 30843772]
[19]
Daley, T; Hughan, K; Rayas, M; Kelly, A; Tangpricha, V. Vitamin D deficiency and its treatment in cystic fibrosis. J Cyst Fibros, 2019, 18 Suppl 2, S66-s73.
[http://dx.doi.org/10.1016/j.jcf.2019.08.022]
[20]
Landel, V.; Stephan, D.; Cui, X.; Eyles, D.; Feron, F. Differential expression of vitamin D-associated enzymes and receptors in brain cell subtypes. J. Steroid Biochem. Mol. Biol., 2018, 177, 129-134.
[http://dx.doi.org/10.1016/j.jsbmb.2017.09.008] [PMID: 28893622]
[21]
Hu, J.; Jia, J.; Zhang, Y.; Miao, R.; Huo, X.; Ma, F. Effects of vitamin D 3 supplementation on cognition and blood lipids: A 12- month randomised, double-blind, placebo-controlled trial. J. Neurol. Neurosurg. Psychiatry, 2018, 89(12), 1341-1347.
[http://dx.doi.org/10.1136/jnnp-2018-318594] [PMID: 30279212]
[22]
Phinney, K.W. Development of a standard reference material for vitamin D in serum. Am. J. Clin. Nutr., 2008, 88(2), 511S-512S.
[http://dx.doi.org/10.1093/ajcn/88.2.511S] [PMID: 18689392]
[23]
Dai, X.Y.; Gong, Y.X. A comparison of factor analytic studies among Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC), WAIS and WAIS-R. Acta Psychol. Sin., 1987, (01), 70-78.
[http://dx.doi.org/10.3788/LOP20084504.0011c]
[24]
Dai, M.; Song, Q.; Wang, X.; Li, Y.; Lin, T.; Liang, R.; Jiang, T.; Shu, X.; Ge, N.; Yue, J. Combined associations of vitamin D and cognitive function with all-cause mortality among older adults in Chinese longevity areas: A prospective cohort study. Front. Public Health, 2023, 111024341http://dx.doi
[http://dx.doi.org/10.3389/fpubh.2023.1024341] [PMID: 37206876]
[25]
Chan, R.; Chan, D.; Woo, J.; Ohlsson, C.; Mellström, D.; Kwok, T.; Leung, P. Association between serum 25-hydroxyvitamin D and psychological health in older Chinese men in a cohort study. J. Affect. Disord., 2011, 130(1-2), 251-259.
[http://dx.doi.org/10.1016/j.jad.2010.10.029] [PMID: 21056909]
[26]
Littlejohns, T.J.; Henley, W.E.; Lang, I.A.; Annweiler, C.; Beauchet, O.; Chaves, P.H.M.; Fried, L.; Kestenbaum, B.R.; Kuller, L.H.; Langa, K.M.; Lopez, O.L.; Kos, K.; Soni, M.; Llewellyn, D.J. Vitamin D and the risk of dementia and Alzheimer disease. Neurology, 2014, 83(10), 920-928.
[http://dx.doi.org/10.1212/WNL.0000000000000755] [PMID: 25098535]
[27]
Toffanello, E.D.; Coin, A.; Perissinotto, E.; Zambon, S.; Sarti, S.; Veronese, N.; De Rui, M.; Bolzetta, F.; Corti, M.C.; Crepaldi, G.; Manzato, E.; Sergi, G. Vitamin D deficiency predicts cognitive decline in older men and women: The Pro.V.A. Study. Neurology, 2014, 83(24), 2292-2298.
[http://dx.doi.org/10.1212/WNL.0000000000001080] [PMID: 25378671]
[28]
Kang, J.; Park, M.; Lee, E.; Jung, J.; Kim, T. The role of vitamin D in Alzheimer’s Disease: A transcriptional regulator of amyloidopathy and gliopathy. Biomedicines, 2022, 10(8), 1824.
[http://dx.doi.org/10.3390/biomedicines10081824] [PMID: 36009371]
[29]
Khandelwal, P.J.; Herman, A.M.; Hoe, H.S.; Rebeck, G.W.; Moussa, C.E.H. Parkin mediates beclin-dependent autophagic clearance of defective mitochondria and ubiquitinated A in AD models. Hum. Mol. Genet., 2011, 20(11), 2091-2102.
[http://dx.doi.org/10.1093/hmg/ddr091] [PMID: 21378096]
[30]
McLean, C.A.; Cherny, R.A.; Fraser, F.W.; Fuller, S.J.; Smith, M.J.; Konrad Vbeyreuther; Bush, A.I.; Masters, C.L. Soluble pool of A? amyloid as a determinant of severity of neurodegeneration in Alzheimer’s disease. Ann. Neurol., 1999, 46(6), 860-866.
[http://dx.doi.org/10.1002/1531-8249(199912)46:6<860::AID-ANA8>3.0.CO;2-M] [PMID: 10589538]
[31]
Ma, F.; Li, Q.; Zhou, X.; Zhao, J.; Song, A.; Li, W.; Liu, H.; Xu, W.; Huang, G. Effects of folic acid supplementation on cognitive function and Aβ-related biomarkers in mild cognitive impairment: a randomized controlled trial. Eur. J. Nutr., 2019, 58(1), 345-356.
[http://dx.doi.org/10.1007/s00394-017-1598-5] [PMID: 29255930]
[32]
Gong, Y.X. Performance of the Wechsler adult intelligence scale and subscales. Chin J Appl Psychol, 1984, (02), 37-41.
[http://dx.doi.org/10.17816/dd77446-51570]
[33]
Llewellyn, D.J.; Lang, I.A.; Langa, K.M.; Muniz-Terrera, G.; Phillips, C.L.; Cherubini, A.; Ferrucci, L.; Melzer, D. Vitamin D and risk of cognitive decline in elderly persons. Arch. Intern. Med., 2010, 170(13), 1135-1141.
[http://dx.doi.org/10.1001/archinternmed.2010.173] [PMID: 20625021]
[34]
Miller, J.W.; Harvey, D.J.; Beckett, L.A.; Green, R.; Farias, S.T.; Reed, B.R.; Olichney, J.M.; Mungas, D.M.; DeCarli, C. Vitamin D status and rates of cognitive decline in a multiethnic cohort of older adults. JAMA Neurol., 2015, 72(11), 1295-1303.
[http://dx.doi.org/10.1001/jamaneurol.2015.2115] [PMID: 26366714]
[35]
Annweiler, C.; Montero-Odasso, M.; Llewellyn, D.J.; Richard-Devantoy, S.; Duque, G.; Beauchet, O. Meta-analysis of memory and executive dysfunctions in relation to vitamin D. J. Alzheimers Dis., 2013, 37(1), 147-171.
[http://dx.doi.org/10.3233/JAD-130452] [PMID: 23948884]
[36]
Al-Amin, M.; Bradford, D.; Sullivan, R.K.P.; Kurniawan, N.D.; Moon, Y.; Han, S.H.; Zalesky, A.; Burne, T.H.J. Vitamin D deficiency is associated with reduced hippocampal volume and disrupted structural connectivity in patients with mild cognitive impairment. Hum. Brain Mapp., 2019, 40(2), 394-406.
[http://dx.doi.org/10.1002/hbm.24380] [PMID: 30251770]
[37]
Fama, R.; Sullivan, E.V. Thalamic structures and associated cognitive functions: Relations with age and aging. Neurosci. Biobehav. Rev., 2015, 54, 29-37.
[http://dx.doi.org/10.1016/j.neubiorev.2015.03.008] [PMID: 25862940]
[38]
Kuźma, E.; Soni, M.; Littlejohns, T.J.; Ranson, J.M.; van Schoor, N.M.; Deeg, D.J.H.; Comijs, H.; Chaves, P.H.M.; Kestenbaum, B.R.; Kuller, L.H.; Lopez, O.L.; Becker, J.T.; Langa, K.M.; Henley, W.E.; Lang, I.A.; Ukoumunne, O.C.; Llewellyn, D.J. Vitamin D and memory decline: Two population-based prospective studies. J. Alzheimers Dis., 2016, 50(4), 1099-1108.
[http://dx.doi.org/10.3233/JAD-150811] [PMID: 26836174]
[39]
Margolis, A.; Bansal, R.; Hao, X.; Algermissen, M.; Erickson, C.; Klahr, K.W.; Naglieri, J.A.; Peterson, B.S. Using IQ discrepancy scores to examine the neural correlates of specific cognitive abilities. J. Neurosci., 2013, 33(35), 14135-14145.
[http://dx.doi.org/10.1523/JNEUROSCI.0775-13.2013] [PMID: 23986248]
[40]
Burgaleta, M.; Johnson, W.; Waber, D.P.; Colom, R.; Karama, S. Cognitive ability changes and dynamics of cortical thickness development in healthy children and adolescents. Neuroimage, 2014, 84, 810-819.
[http://dx.doi.org/10.1016/j.neuroimage.2013.09.038] [PMID: 24071525]
[41]
Wang, J.; Zou, Y.Z.; Cui, J.F. Reliability and construct validity of the Chinese version of the wechsler adult intelligence scale-fourth edition. Chin. Ment. Health J., 2013, 27(09), 692-697.
[http://dx.doi.org/10.1016/10.12677/ns.2021.101005]
[42]
Touvier, M.; Deschasaux, M.; Montourcy, M.; Sutton, A.; Charnaux, N.; Kesse-Guyot, E.; Assmann, K.E.; Fezeu, L.; Latino-Martel, P.; Druesne-Pecollo, N.; Guinot, C.; Latreille, J.; Malvy, D.; Galan, P.; Hercberg, S.; Le Clerc, S.; Souberbielle, J.C.; Ezzedine, K. Determinants of vitamin D status in Caucasian adults: Influence of sun exposure, dietary intake, sociodemographic, lifestyle, anthropometric, and genetic factors. J. Invest. Dermatol., 2015, 135(2), 378-388.
[http://dx.doi.org/10.1038/jid.2014.400] [PMID: 25211176]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy