Vitamin D insufficiency and cognitive impairment in Asians: a multi-ethnic population-based study and meta-analysis
Journal of Internal Medicine, Article first published online: 1 APR 2016, DOI: 10.1111/joim.12491
C. Annweiler1,2, D. Milea3,4,5,6, H. E. Whitson7,8,9, C.-Y. Cheng3,4,10,11, T.-Y. Wong3,4,10,11, M. K. Ikram3,12, E. L. Lamoureux3,4,10,11 andC. Sabanayagam3,10,11,*
- Overview Alzheimer's-Cognition and Vitamin D
- Schizophrenia increased 40 percent for Spring births after Danes stopped vitamin D fortification – April 2014
- Vitamin D reduces Alzheimer’s disease in at least 11 ways – Jan 2013
- Schizophrenia treated by 6 months of Omega-3 – RCT Nov 2015
- 2,000 IU of vitamin D reduced schizophrenia chance by 77 percent (male infants) - 2004
Items in both categories of Cognition and Meta-analysis
- Alzheimer’s 1.6X more likely if vitamin D is less than 25 ng – meta-analysis July 2023
- Alzheimer’s patients have less Magnesium – meta-analysis Jan 2022
- Delirium or cognitive problems after surgery 1.5X more likely if low vitamin D –meta-analysis Aug 2022
- 2X higher risk of Alzheimer’s if poor Vitamin D Receptor – Meta-analysis June 2021
- Alzheimer’s Disease risk is 1.9 X higher if Vitamin D deficient- meta-analysis Feb 2020
- Alzheimer’s Disease risk is 1.3X higher if Vitamin D deficient – meta-analysis Nov 2019
- Mental disorders fought by Omega-3 etc. - meta-meta-analysis Oct 2019
- Alzheimer's risk increased 7 percent for every 4 ng decrease in Vitamin D– meta-analysis Nov 2018
- Dementia is associated with low vitamin D - many studies
- Risk of Dementia and Alzheimer's reduced by higher levels of Vitamin D – meta-analysis Feb 2018
- Poor cognition 26 percent more likely if low Vitamin D (29 studies) – meta-analysis July 2017
- Dementia risk factor is increased by 1.5 if low vitamin D – meta-analysis Jan 2017
- Omega-3 helps childhood cognition – meta-analysis April 2016
- Poor cognition associated with low vitamin D in elderly (Asians now too) – meta-analysis March 2016
- Cognitive decline in elderly slowed by Omega-3 – meta-analysis May 2015
- Alzheimer’s disease 21 percent more likely if low vitamin D – meta-analysis Aug 2015
- Parkinson's and Alzheimer's: associations with vitamin D receptor genes and race – meta-analysis July 2014
- Brain (Alzheimer’s) worked better with Vitamin D intervention – meta-analysis July 2013
- Alzheimer’s and Parkinson’s diseases associated with low vitamin D – meta-analysis June 2013
- Alzheimer's Disease more likely with low vitamin D – meta-analysis Oct 2012
- Alzheimer disease associated with 2.5 ng less vitamin D – meta-analysis Sept 2012
- Cognitive Impairment 2.4X more likely if low vitamin D – meta-analysis July 2012
Background
The relationship between vitamin D insufficiency and cognitive impairment remains equivocal in Asians. We examined the association between circulating 25-hydroxyvitamin D (25OHD) concentration and cognitive performance in a large multi-ethnic Singaporean population-based study. We also conducted a meta-analysis of 25OHD concentrations amongst cognitively impaired older adults in Asia.
Methods
Our population-based cross-sectional study included 2273 persons ≥60 years of age from the Singapore Epidemiology of Eye Diseases (SEED) study (mean ± SD age 70.4 ± 6.2 years; 44.7% female), who were categorized according to 25OHD concentration (i.e. ≤10, 10.1–20 and >20 ng mL−1). The 25OHD concentration was measured and adjusted to reflect a deseasonalized value. Cognition was assessed using the total and domain scores of the Abbreviated Mental Test (AMT). Global cognitive impairment was defined as AMT score of ≤6 if 0–6 years of education and AMT score of ≤8 if >7 years of education. Fully adjusted multivariate models were used. We included seven studies in a meta-analysis of 25OHD and cognition in Asia (6068 participants; 1179 cognitively impaired cases).
Results
Participants with 25OHD levels >20 ng mL−1 (n = 1302) had higher AMT total scores (mean ± SD 8.5 ± 1.9) and were less likely to have cognitive impairment (14.1%) than participants with lower 25OHD levels (overall P < 0.001, P-trend < 0.001). Deseasonalized 25OHD concentration was associated with AMT score (β = 0.10 per 10 ng mL−1, P = 0.035). Vitamin D insufficiency (25OHD ≤20 ng mL−1) was associated with global cognitive impairment (OR 1.56, P = 0.028). Specifically, 25OHD concentration correlated with semantic memory (r = 0.08, P = 0.009) and orientation in time (r = 0.09, P = 0.003). In the meta-analysis, the pooled mean 25OHD difference was −6.83 ng mL−1 (95% confidence interval −11.36; −2.30), indicating lower 25OHD concentrations amongst cognitively impaired compared to cognitively healthy participants in Asia.
Conclusion
Vitamin D insufficiency is associated with a greater likelihood of and more severe cognitive impairment in Asian populations.