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Vitamin D deficiency predicts cognitive decline in older men and women: The Pro.V.A. Study.

Abstract

OBJECTIVE

To test the hypothesis that hypovitaminosis D is associated with a higher risk of cognitive decline over a 4.4-year follow-up in a large sample of older adults.

METHODS

This research was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study of 1,927 elderly subjects. Serum 25-hydroxyvitamin D (25OHD) levels were measured at the baseline. Global cognitive function was measured with the Mini-Mental State Examination (MMSE); scores lower than 24 were indicative of cognitive dysfunction, and a decline of 3 or more points on the MMSE over the follow-up was considered as clinically significant. Analyses were adjusted for relevant confounders, including health and performance status.

RESULTS

Participants with 25OHD deficiency (<50 nmol/L) or insufficiency (50-75 nmol/L) were more likely to have declining MMSE scores during the follow-up than those who were 25OHD sufficient (≥75 nmol/L). Among participants cognitively intact (baseline MMSE scores ≥24 and without diagnosis of dementia), the multivariate adjusted relative risk (95% confidence interval [CI]) of the onset of cognitive dysfunction was 1.36 (95% CI: 1.04-1.80; p = 0.02) for those with vitamin D deficiency and 1.29 (95% CI: 1.00-1.76; p = 0.05) for those with vitamin D insufficiency by comparison with individuals with normal 25OHD levels.

CONCLUSION

The results of our study support an independent association between low 25OHD levels and cognitive decline in elderly individuals. In cognitively intact elderly subjects, 25OHD levels below 75 nmol/L are already predictive of global cognitive dysfunction at 4.4 years.

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    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy. elenadebora.toffanello@sanita.padova.it.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    ,

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    From the Department of Medical and Surgical Sciences (Department of Medicine-DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.

    Source

    Neurology 83:24 2014 12 09 pg 2292-8

    MeSH

    Aged
    Aged, 80 and over
    Blood Chemical Analysis
    Cognition Disorders
    Cohort Studies
    Female
    Follow-Up Studies
    Humans
    Logistic Models
    Male
    Multivariate Analysis
    Neuropsychological Tests
    Prognosis
    Risk
    Vitamin D
    Vitamin D Deficiency

    Pub Type(s)

    Journal Article
    Observational Study
    Research Support, N.I.H., Intramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25378671

    Citation

    Toffanello, Elena D., et al. "Vitamin D Deficiency Predicts Cognitive Decline in Older Men and Women: the Pro.V.A. Study." Neurology, vol. 83, no. 24, 2014, pp. 2292-8.
    Toffanello ED, Coin A, Perissinotto E, et al. Vitamin D deficiency predicts cognitive decline in older men and women: The Pro.V.A. Study. Neurology. 2014;83(24):2292-8.
    Toffanello, E. D., Coin, A., Perissinotto, E., Zambon, S., Sarti, S., Veronese, N., ... Sergi, G. (2014). Vitamin D deficiency predicts cognitive decline in older men and women: The Pro.V.A. Study. Neurology, 83(24), pp. 2292-8. doi:10.1212/WNL.0000000000001080.
    Toffanello ED, et al. Vitamin D Deficiency Predicts Cognitive Decline in Older Men and Women: the Pro.V.A. Study. Neurology. 2014 12 9;83(24):2292-8. PubMed PMID: 25378671.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin D deficiency predicts cognitive decline in older men and women: The Pro.V.A. Study. AU - Toffanello,Elena D, AU - Coin,Alessandra, AU - Perissinotto,Egle, AU - Zambon,Sabina, AU - Sarti,Silvia, AU - Veronese,Nicola, AU - De Rui,Marina, AU - Bolzetta,Francesco, AU - Corti,Maria-Chiara, AU - Crepaldi,Gaetano, AU - Manzato,Enzo, AU - Sergi,Giuseppe, Y1 - 2014/11/05/ PY - 2014/11/8/entrez PY - 2014/11/8/pubmed PY - 2015/4/2/medline SP - 2292 EP - 8 JF - Neurology JO - Neurology VL - 83 IS - 24 N2 - OBJECTIVE: To test the hypothesis that hypovitaminosis D is associated with a higher risk of cognitive decline over a 4.4-year follow-up in a large sample of older adults. METHODS: This research was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study of 1,927 elderly subjects. Serum 25-hydroxyvitamin D (25OHD) levels were measured at the baseline. Global cognitive function was measured with the Mini-Mental State Examination (MMSE); scores lower than 24 were indicative of cognitive dysfunction, and a decline of 3 or more points on the MMSE over the follow-up was considered as clinically significant. Analyses were adjusted for relevant confounders, including health and performance status. RESULTS: Participants with 25OHD deficiency (<50 nmol/L) or insufficiency (50-75 nmol/L) were more likely to have declining MMSE scores during the follow-up than those who were 25OHD sufficient (≥75 nmol/L). Among participants cognitively intact (baseline MMSE scores ≥24 and without diagnosis of dementia), the multivariate adjusted relative risk (95% confidence interval [CI]) of the onset of cognitive dysfunction was 1.36 (95% CI: 1.04-1.80; p = 0.02) for those with vitamin D deficiency and 1.29 (95% CI: 1.00-1.76; p = 0.05) for those with vitamin D insufficiency by comparison with individuals with normal 25OHD levels. CONCLUSION: The results of our study support an independent association between low 25OHD levels and cognitive decline in elderly individuals. In cognitively intact elderly subjects, 25OHD levels below 75 nmol/L are already predictive of global cognitive dysfunction at 4.4 years. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/25378671/Vitamin_D_deficiency_predicts_cognitive_decline_in_older_men_and_women:_The_Pro_V_A__Study_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=25378671 DB - PRIME DP - Unbound Medicine ER -