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January 05, 2010; 74 (1) Articles

25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services

J. S. Buell, B. Dawson-Hughes, T. M. Scott, D. E. Weiner, G. E. Dallal, W. Q. Qui, P. Bergethon, I. H. Rosenberg, M. F. Folstein, S. Patz, R. A. Bhadelia, K. L. Tucker
First published November 25, 2009, DOI: https://doi.org/10.1212/WNL.0b013e3181beecb7
J. S. Buell
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B. Dawson-Hughes
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T. M. Scott
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D. E. Weiner
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G. E. Dallal
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W. Q. Qui
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P. Bergethon
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I. H. Rosenberg
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M. F. Folstein
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S. Patz
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R. A. Bhadelia
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Citation
25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services
J. S. Buell, B. Dawson-Hughes, T. M. Scott, D. E. Weiner, G. E. Dallal, W. Q. Qui, P. Bergethon, I. H. Rosenberg, M. F. Folstein, S. Patz, R. A. Bhadelia, K. L. Tucker
Neurology Jan 2010, 74 (1) 18-26; DOI: 10.1212/WNL.0b013e3181beecb7

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Abstract

Background: Vitamin D deficiency has potential adverse effects on neurocognitive health and subcortical function. However, no studies have examined the association between vitamin D status, dementia, and cranial MRI indicators of cerebrovascular disease (CVD).

Methods: Cross-sectional investigation of 25-hydroxyvitamin D [25(OH)D], dementia, and MRI measures of CVD in elders receiving home care (aged 65–99 years) from 2003 to 2007.

Results: Among 318 participants, the mean age was 73.5 ± 8.1 years, 231 (72.6%) were women, and 109 (34.3%) were black. 25(OH)D concentrations were deficient (<10 ng/mL) in 14.5% and insufficient (10–20 ng/mL) in 44.3% of participants. There were 76 participants (23.9%) with dementia, 41 of which were classified as probable AD. Mean 25(OH)D concentrations were lower in subjects with dementia (16.8 vs 20.0 ng/mL, p < 0.01). There was a higher prevalence of dementia among participants with 25(OH)D insufficiency (≤20 ng/mL) (30.5% vs 14.5%, p < 0.01). 25(OH)D deficiency was associated with increased white matter hyperintensity volume (4.9 vs 2.9 mL, p < 0.01), grade (3.0 vs 2.2, p = 0.04), and prevalence of large vessel infarcts (10.1% vs 6.9%, p < 0.01). After adjustment for age, race, sex, body mass index, and education, 25(OH)D insufficiency (≤20 ng/mL) was associated with more than twice the odds of all-cause dementia (odds ratio [OR] = 2.3, 95% confidence interval [CI] 1.2–4.2), Alzheimer disease (OR = 2.5, 95% CI 1.1–6.1), and stroke (with and without dementia symptoms) (OR = 2.0, 95% CI 1.0–4.0).

Conclusions: Vitamin D insufficiency and deficiency was associated with all-cause dementia, Alzheimer disease, stroke (with and without dementia symptoms), and MRI indicators of cerebrovascular disease. These findings suggest a potential vasculoprotective role of vitamin D.

Glossary

25(OH)D=
25-hydroxyvitamin D;
AIREN=
Association Internationale pour la Recherché et l'Enseignement en Neurosciences;
BMI=
body mass index;
CI=
confidence interval;
CVD=
cerebrovascular disease;
DSM-IV=
Diagnostic and Statistical Manual of Mental Disorders, 4th edition;FFQ;
FLAIR=
fluid-attenuation inversion recovery;
GFR=
glomerular filtration rate;
MPRAGE=
magnetization prepared rapid acquisition gradient echo;
MTL=
medial temporal lobe;
NAME=
Nutrition and Memory in Elders;
NINDS=
National Institute of Neurological Disorders and Stroke;
OR=
odds ratio;
WMH=
white matter hyperintensities.
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Letters: Rapid online correspondence

  • 25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services
    • Cédric Annweiler, Angers University Hospital,, 49933 Angers, Cedex 9, Franceceannweiler@chu-angers.fr
    • Didier Le Gall, Bruno Fantino, and Olivier Beauchet.
    Submitted March 08, 2010
  • Reply from the authors
    • Katherine L. Tucker, Northeastern University, 316 Robinson Hall, Boston, MA 02115kl.tucker@neu.edu
    • Jennifer S Buell (Boston, MA; jennifer.buell@gmail.com)
    Submitted March 08, 2010
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