PT  - JOURNAL ARTICLE
AU  - Buell, J. S.
AU  - Dawson-Hughes, B.
AU  - Scott, T. M.
AU  - Weiner, D. E.
AU  - Dallal, G. E.
AU  - Qui, W. Q.
AU  - Bergethon, P.
AU  - Rosenberg, I. H.
AU  - Folstein, M. F.
AU  - Patz, S.
AU  - Bhadelia, R. A.
AU  - Tucker, K. L.
TI  - 25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services
AID  - 10.1212/WNL.0b013e3181beecb7
DP  - 2010 Jan 05
TA  - Neurology
PG  - 18--26
VI  - 74
IP  - 1
4099  - http://n.neurology.org/content/74/1/18.short
4100  - http://n.neurology.org/content/74/1/18.full
SO  - Neurology2010 Jan 05; 74
AB  - 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. 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.