We thank Dr. Rosenberg for the interesting comment. Indeed, in our article, [1] we referenced Bolland et al. for an acute (steep) increase in serum calcium being one possible mechanism. [2] This acute increase is correctly detailed by Dr. Rosenberg, just to a modest degree. However, in the pathomechanism of cell death, the acute increase in itself, not the amount of the increase, might be important especially in vulnerable neurons already compromised by cerebrovascular disease. Additionally, there are several possible mechanisms of calcium supplements in the pathogenesis of dementia.
We agree with Dr. Rosenberg that further research should look for mechanisms outside the realm of calcium pharmacokinetics.
1. Kern J, Kern S, Blennow K, et al. Calcium supplementation and risk of dementia in women with cerebrovascular disease. Neurology Epub 2016 Aug 17.
2. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691.
For disclosures, please contact the editorial office at journal@neurology.org.
We thank Dr. Rosenberg for the interesting comment. Indeed, in our article, [1] we referenced Bolland et al. for an acute (steep) increase in serum calcium being one possible mechanism. [2] This acute increase is correctly detailed by Dr. Rosenberg, just to a modest degree. However, in the pathomechanism of cell death, the acute increase in itself, not the amount of the increase, might be important especially in vulnerable neurons already compromised by cerebrovascular disease. Additionally, there are several possible mechanisms of calcium supplements in the pathogenesis of dementia.
We agree with Dr. Rosenberg that further research should look for mechanisms outside the realm of calcium pharmacokinetics.
1. Kern J, Kern S, Blennow K, et al. Calcium supplementation and risk of dementia in women with cerebrovascular disease. Neurology Epub 2016 Aug 17.
2. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691.
For disclosures, please contact the editorial office at journal@neurology.org.