Importance of Vit D AGAIN!!

[Guest guest]

Vitamin D deficiency appears to increase the risk for cognitive impairment,

a large, population-based study of older women shows.

Presented here at the American Academy of Neurology 62nd Annual Meeting, the

cross-sectional study shows older women with serum 25-hydroxyvitamin D

(25OHD) levels of less than 10 ng/mL had a 2-fold increased risk of global

cognitive impairment compared with their counterparts who were not vitamin D

deficient.

" After accounting for all potential confounders, our findings showed an

association between vitamin D deficiency and global cognitive impairment.

These results are congruent with fundamental research and add to the growing

body of evidence in favor of the neurological action of vitamin D, "

principal investigator, Cédric Annweiler, MD, Angers University Hospital in

France, told *Medscape Psychiatry*.

Dr. Annweiler said he became interested in looking at the potential impact

of vitamin D on cognitive function when studying risk factors associated

with falling in older women in the Epidemiologie de l'Osteoporose (EPIDOS)

study. This large, prospective, observational, multicenter cohort study was

designed to evaluate risk factors for hip fracture among more than 7500

healthy, community-dwelling older women.

Typically associated with skeletal disorders, vitamin D deficiency is also

associated with neuromuscular disorders in humans and severe coordination

disorders in animal research, said Dr. Annweiler.

*Specific CNS Effects *

A neurosteroid hormone, research shows it has specific effects on the

central nervous system (CNS), including regulation of neurotransmission,

neuroimmunomodulation, and neuroprotection.

According to Dr. Annweiler, few studies have investigated the association

between low serum 25OHD and cognitive impairment. A recent systematic review

of the literature conducted by his team produced mixed results (*Eur J

Neurol.* 2009;16:1083-1089).

However, the investigators speculated that these inconclusive findings may

be explained by the lack of control for potential confounders.

To determine whether there was an association between vitamin D deficiency

and global cognitive impairment, the investigators studied 752 women from

the EPIDOS cohort. Participants were 75 years and older and were divided

into 2 groups according to serum 25OHD concentration — deficient (<10 ng/mL)

or nondeficient (≥10 ng/mL).

Cognitive impairment was determined using the Pfeiffer Short Portable Mental

State Questionnaire (SPMSQ), a validated, 10-item, composite questionnaire

used to screen for organic brain diseases. Cognitive impairment was defined

as an SPMSQ score of less than 8.

Investigators controlled for a variety of potential confounders, including

age, body mass index, number of chronic diseases, current hypertension,

current depression, use of psychoactive drugs, education level, regular

physical activity, and serum intact parathyroid hormone and calcium.

*Rampant Problem in the Elderly *

The results showed that compared with women who were not vitamin D deficient

(n = 623) their vitamin D deficient counterparts had a lower mean SPMSQ

score (*P *< .001) and were also more likely to have an SPMSQ score of less

than 8 (*P *= .006).

Adjusted analysis revealed that vitamin D was significantly associated with

cognitive impairment (odds ratio, 2.03; *P *= .001).

The clinical implications, said Dr. Annweiler, appear clear — clinicians

need to assess and treat vitamin D deficiency in their older patients for a

variety of health reasons that may include preservation of cognitive

function.

Vitamin D deficiency is common in the general population but is rampant

among the elderly. According to Dr. Annweiler, it is estimated that 70% to

80% of individuals older than 75 years are vitamin D deficient.

Currently, adequate intakes of vitamin D for 51- to 70-year-olds are 400 IU

per day and 600 IU for those older than 70 years to maintain a 25OHD level

of 30 ng/mL or more. However, Dr. Annweiler noted that these recommendations

are based primarily on preservation of bone health alone.

The reason the elderly are more vulnerable to vitamin D deficiency than

younger individuals are several-fold and include decreased exposure to

sunlight and inadequate dietary intake. In addition, said Dr. Annweiler, the

skin of older people is not as efficient at synthesizing UV-B rays into

vitamin D.

" This study provides more evidence to support [vitamin D] supplementation in

our elderly patients to normalize serum concentrations and help sustain good

health. Although we are not certain yet, it may be that this will also be a

viable way to prevent or treat cognitive impairment and possibly turn out to

be a new management strategy for dementia, " said Dr. Annweiler.

The study was initially published earlier this year in the January 5 issue

of *Neurology*. At that time, in an accompanying editorial, W. Mill,

PhD, UC Medical Center, Sacramento, California, echoed Dr. Annweiler's

clinical recommendation (*Neurology. *2010;74:13-15).

What are needed now are placebo-controlled intervention studies to determine

whether vitamin D supplements will protect against age-related cognitive

decline. In the meantime, neurologists and geriatricians should be aware of

the high prevalence of vitamin D deficiency in their patient populations and

the possibility that supplementation could be beneficial, " Dr. Mill writes.

Dr. Annweiler said his team plans to prospectively follow up the cohort and

examine the potential relationship between vitamin D status and incident

dementia. In addition, his team is exploring the possibility of conducting a

clinical trial to look at the impact of supplementation on cognitive

outcomes.

*The study was funded by the French Ministry of Health. Dr. Annweiler and

Dr. have disclosed no relevant financial relationships. *

American Academy of Neurology (AAN) 62nd Annual Meeting: Abstract S34.003.

Presented April 14, 2010.

www.medscape.com

--

Ortiz, MS, RD

" I love being married. It's so great to find that one special person you

want to annoy for the rest of your life. "

" Cause of obesity, heart disease and cancer: Look at the end of your fork "