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Assessing the Relationship between Vitamin D Status and Impairments in Cognitive and Physical Performance in Older Adults Using a Dual Task Physical Performance Test.

Abstract

BACKGROUND

Vitamin D deficiency has been associated with an increased risk of falls in older adults. Several studies have demonstrated an association between vitamin D deficiency and gait and cognitive impairments, which are two risk factors for falls in the elderly. There is lack of research about the role of vitamin D in cognitive function in the context of mobility.

OBJECTIVE

The purpose of this study was to evaluate the association between vitamin D status with the age-related changes in mobility through higher order cognitive function using a dual task physical performance test.

DESIGN

Cross-sectional.

SETTING

Community-dwelling older adult population located in Miami, Fl.

PARTICIPANTS

Healthy participants over the age of 55 (n=97) who participated in the parent interventional study.

MEASUREMENTS

Participants completed assessments that included serum levels of vitamin D, surveys, and dual task physical performance tests. Spearman's correlations, independent t-tests, repeated measures ANOVAs and multiple logistic regressions were used to examine the relationship between vitamin D insufficiency (25-hydroxyvitamin D <30 ng/ml) and sufficiency (≥30 ng/ml) and dual task physical performance variables. The significance level was set at α=0.05.

RESULTS

There were no significant associations between vitamin D insufficiency and gait velocity during either task. Using Spearman correlations, slower single (P=0.011) and dual task counting rates (P=0.006) were significantly associated with vitamin D insufficiency. Independent t-tests showed dual and single task counting rates were significantly lower in the vitamin D insufficient group compared to the sufficient group (P=0.018 and P=0.028, respectively). The results for the ANOVAs indicated that velocities and counting rates were not significantly different by vitamin D status (Wilk's Lambda =0.999; F (1, 95) =.11, P=.740) (Wilk's Lambda =.999, F(1,95)=.13, P=.718). Vitamin D status was not significantly associated with dual task physical performance (defined as the difference in dual and single task) in gait velocity (OR=1.00, 95% CI: 0.98; 1.02, P=0.772) and counting rate (OR=1.684, 95% CI: 0.15; 19.57, P=0.677), when controlling for confounders.

CONCLUSIONS

Since counting backward is a mental tracking task, which is a component of executive function, our results suggest a relationship between vitamin D insufficiency and executive dysfunction. Executive dysfunction has been previously associated with fall risks in the elderly, and it could be a possible mediator between vitamin D and falls. Our data suggest that cognition may play a significant role in vitamin D's influence on falls, while motor function may play a lesser role.

Links

Authors+Show Affiliations

,

Johanna Lopez, Ph.D., RDN/LDN. Clinical and Research Dietitian, Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, FL 33136 jlopez2@miami.edu Ph: 305-243-4113 or 786-973-2363 Fax: 305-243-1619.

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Source

MeSH

Analysis of Variance
Cognitive Dysfunction
Cross-Sectional Studies
Executive Function
Humans
Logistic Models
Mathematical Concepts
Middle Aged
Movement Disorders
Neuropsychological Tests
Psychomotor Performance
Vitamin D
Vitamin D Deficiency
Walking Speed

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29188857

Citation

Lopez, J, et al. "Assessing the Relationship Between Vitamin D Status and Impairments in Cognitive and Physical Performance in Older Adults Using a Dual Task Physical Performance Test." The Journal of Prevention of Alzheimer's Disease, vol. 4, no. 1, 2017, pp. 29-36.
Lopez J, Campa A, Lewis JE, et al. Assessing the Relationship between Vitamin D Status and Impairments in Cognitive and Physical Performance in Older Adults Using a Dual Task Physical Performance Test. J Prev Alzheimers Dis. 2017;4(1):29-36.
Lopez, J., Campa, A., Lewis, J. E., Huffman, F. G., Liuzzi, J. P., Li, T., ... Woolger, J. M. (2017). Assessing the Relationship between Vitamin D Status and Impairments in Cognitive and Physical Performance in Older Adults Using a Dual Task Physical Performance Test. The Journal of Prevention of Alzheimer's Disease, 4(1), pp. 29-36. doi:10.14283/jpad.2016.114.
Lopez J, et al. Assessing the Relationship Between Vitamin D Status and Impairments in Cognitive and Physical Performance in Older Adults Using a Dual Task Physical Performance Test. J Prev Alzheimers Dis. 2017;4(1):29-36. PubMed PMID: 29188857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessing the Relationship between Vitamin D Status and Impairments in Cognitive and Physical Performance in Older Adults Using a Dual Task Physical Performance Test. AU - Lopez,J, AU - Campa,A, AU - Lewis,J E, AU - Huffman,F G, AU - Liuzzi,J P, AU - Li,T, AU - Martinez,A H, AU - Ferris,S M, AU - Rasul,A, AU - Farooqi,A, AU - Lopez Medrano,A M, AU - Atlas,S E, AU - Tiozzo,E, AU - Konefal,J, AU - Woolger,J M, PY - 2017/12/1/entrez PY - 2017/12/1/pubmed PY - 2018/9/25/medline KW - Vitamin D status KW - dual task KW - executive function KW - older adult KW - physical performance SP - 29 EP - 36 JF - The journal of prevention of Alzheimer's disease JO - J Prev Alzheimers Dis VL - 4 IS - 1 N2 - BACKGROUND: Vitamin D deficiency has been associated with an increased risk of falls in older adults. Several studies have demonstrated an association between vitamin D deficiency and gait and cognitive impairments, which are two risk factors for falls in the elderly. There is lack of research about the role of vitamin D in cognitive function in the context of mobility. OBJECTIVE: The purpose of this study was to evaluate the association between vitamin D status with the age-related changes in mobility through higher order cognitive function using a dual task physical performance test. DESIGN: Cross-sectional. SETTING: Community-dwelling older adult population located in Miami, Fl. PARTICIPANTS: Healthy participants over the age of 55 (n=97) who participated in the parent interventional study. MEASUREMENTS: Participants completed assessments that included serum levels of vitamin D, surveys, and dual task physical performance tests. Spearman's correlations, independent t-tests, repeated measures ANOVAs and multiple logistic regressions were used to examine the relationship between vitamin D insufficiency (25-hydroxyvitamin D <30 ng/ml) and sufficiency (≥30 ng/ml) and dual task physical performance variables. The significance level was set at α=0.05. RESULTS: There were no significant associations between vitamin D insufficiency and gait velocity during either task. Using Spearman correlations, slower single (P=0.011) and dual task counting rates (P=0.006) were significantly associated with vitamin D insufficiency. Independent t-tests showed dual and single task counting rates were significantly lower in the vitamin D insufficient group compared to the sufficient group (P=0.018 and P=0.028, respectively). The results for the ANOVAs indicated that velocities and counting rates were not significantly different by vitamin D status (Wilk's Lambda =0.999; F (1, 95) =.11, P=.740) (Wilk's Lambda =.999, F(1,95)=.13, P=.718). Vitamin D status was not significantly associated with dual task physical performance (defined as the difference in dual and single task) in gait velocity (OR=1.00, 95% CI: 0.98; 1.02, P=0.772) and counting rate (OR=1.684, 95% CI: 0.15; 19.57, P=0.677), when controlling for confounders. CONCLUSIONS: Since counting backward is a mental tracking task, which is a component of executive function, our results suggest a relationship between vitamin D insufficiency and executive dysfunction. Executive dysfunction has been previously associated with fall risks in the elderly, and it could be a possible mediator between vitamin D and falls. Our data suggest that cognition may play a significant role in vitamin D's influence on falls, while motor function may play a lesser role. SN - 2426-0266 UR - https://www.unboundmedicine.com/medline/citation/29188857/Assessing_the_Relationship_between_Vitamin_D_Status_and_Impairments_in_Cognitive_and_Physical_Performance_in_Older_Adults_Using_a_Dual_Task_Physical_Performance_Test_ L2 - https://medlineplus.gov/vitamind.html DB - PRIME DP - Unbound Medicine ER -