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A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition.
J Am Geriatr Soc 2017; 65(10):2161-2168JA

Abstract

BACKGROUND/OBJECTIVE

With an aging population and no cure for dementia on the horizon, risk factor modification prior to disease onset is an urgent health priority. Therefore, this review examined the effect of low vitamin D status or vitamin D supplementation on cognition in midlife and older adults without a diagnosis of dementia.

DESIGN

Systematic review and random effect meta-analysis.

SETTING

Observational (cross-sectional and longitudinal cohort) studies comparing low and high vitamin D status and interventions comparing vitamin D supplementation with a control group were included in the review and meta-analysis.

PARTICIPANTS

Studies including adults and older adults without a dementia diagnosis were included.

MEASUREMENTS

Medline (PubMed), AMED, Psych INFO, and Cochrane Central databases were searched for articles until August 2016. The Newcastle-Ottawa Scale and Physiotherapy Evidence Database assessed methodological quality of all studies.

RESULTS

Twenty-six observational and three intervention studies (n = 19-9,556) were included in the meta-analysis. Low vitamin D was associated with worse cognitive performance (OR = 1.24, CI = 1.14-1.35) and cognitive decline (OR = 1.26, CI = 1.09-1.23); with cross-sectional yielding a stronger effect compared to longitudinal studies. Vitamin D supplementation showed no significant benefit on cognition compared with control (SMD = 0.21, CI = -0.05 to 0.46).

CONCLUSION

Observational evidence demonstrates low vitamin D is related to poorer cognition; however, interventional studies are yet to show a clear benefit from vitamin D supplementation. From the evidence to date, there is likely a therapeutic age window relevant to the development of disease and therefore vitamin D therapy. Longitudinal lifespan studies are necessary to depict the optimal timing and duration in which repletion of vitamin D may protect against cognitive decline and dementia in aging, to better inform trials and practice towards a successful therapy.

Authors+Show Affiliations

Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia.Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia. Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

28758188

Citation

Goodwill, Alicia M., and Cassandra Szoeke. "A Systematic Review and Meta-Analysis of the Effect of Low Vitamin D On Cognition." Journal of the American Geriatrics Society, vol. 65, no. 10, 2017, pp. 2161-2168.
Goodwill AM, Szoeke C. A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition. J Am Geriatr Soc. 2017;65(10):2161-2168.
Goodwill, A. M., & Szoeke, C. (2017). A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition. Journal of the American Geriatrics Society, 65(10), pp. 2161-2168. doi:10.1111/jgs.15012.
Goodwill AM, Szoeke C. A Systematic Review and Meta-Analysis of the Effect of Low Vitamin D On Cognition. J Am Geriatr Soc. 2017;65(10):2161-2168. PubMed PMID: 28758188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition. AU - Goodwill,Alicia M, AU - Szoeke,Cassandra, Y1 - 2017/07/31/ PY - 2017/8/2/pubmed PY - 2017/10/20/medline PY - 2017/8/1/entrez KW - cognitive aging KW - cognitive decline KW - dementia KW - neuropsychology KW - prevention KW - vitamin D SP - 2161 EP - 2168 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 65 IS - 10 N2 - BACKGROUND/OBJECTIVE: With an aging population and no cure for dementia on the horizon, risk factor modification prior to disease onset is an urgent health priority. Therefore, this review examined the effect of low vitamin D status or vitamin D supplementation on cognition in midlife and older adults without a diagnosis of dementia. DESIGN: Systematic review and random effect meta-analysis. SETTING: Observational (cross-sectional and longitudinal cohort) studies comparing low and high vitamin D status and interventions comparing vitamin D supplementation with a control group were included in the review and meta-analysis. PARTICIPANTS: Studies including adults and older adults without a dementia diagnosis were included. MEASUREMENTS: Medline (PubMed), AMED, Psych INFO, and Cochrane Central databases were searched for articles until August 2016. The Newcastle-Ottawa Scale and Physiotherapy Evidence Database assessed methodological quality of all studies. RESULTS: Twenty-six observational and three intervention studies (n = 19-9,556) were included in the meta-analysis. Low vitamin D was associated with worse cognitive performance (OR = 1.24, CI = 1.14-1.35) and cognitive decline (OR = 1.26, CI = 1.09-1.23); with cross-sectional yielding a stronger effect compared to longitudinal studies. Vitamin D supplementation showed no significant benefit on cognition compared with control (SMD = 0.21, CI = -0.05 to 0.46). CONCLUSION: Observational evidence demonstrates low vitamin D is related to poorer cognition; however, interventional studies are yet to show a clear benefit from vitamin D supplementation. From the evidence to date, there is likely a therapeutic age window relevant to the development of disease and therefore vitamin D therapy. Longitudinal lifespan studies are necessary to depict the optimal timing and duration in which repletion of vitamin D may protect against cognitive decline and dementia in aging, to better inform trials and practice towards a successful therapy. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/28758188/A_Systematic_Review_and_Meta_Analysis_of_The_Effect_of_Low_Vitamin_D_on_Cognition_ L2 - https://doi.org/10.1111/jgs.15012 DB - PRIME DP - Unbound Medicine ER -