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Vitamin D Deficiency Is Associated With Low Mood and Worse Cognitive Performance in Older Adults

https://doi.org/10.1097/01.JGP.0000240986.74642.7cGet rights and content

Background

Vitamin D deficiency is common in older adults and has been implicated in psychiatric and neurologic disorders. This study examined the relationship among vitamin D status, cognitive performance, mood, and physical performance in older adults.

Methods

A cross-sectional group of 80 participants, 40 with mild Alzheimer disease (AD) and 40 nondemented persons, were selected from a longitudinal study of memory and aging. Cognitive function was assessed using the Short Blessed Test (SBT), Mini-Mental State Exam (MMSE), Clinical Dementia Rating (CDR; a higher Sum of Boxes score indicates greater dementia severity), and a factor score from a neuropsychometric battery; mood was assessed using clinician's diagnosis and the depression symptoms inventory. The Physical Performance Test (PPT) was used to measure functional status. Serum 25-hydroxyvitamin D levels were measured for all participants.

Results

The mean vitamin D level in the total sample was 18.58 ng/mL (standard deviation: 7.59); 58% of the participants had abnormally low vitamin D levels defined as less than 20 ng/mL. After adjusting for age, race, gender, and season of vitamin D determination, vitamin D deficiency was associated with presence of an active mood disorder (odds ratio: 11.69, 95% confidence interval: 2.04–66.86; Wald χ2 = 7.66, df = 2, p = 0.022). Using the same covariates in a linear regression model, vitamin D deficiency was associated with worse performance on the SBT (F = 5.22, df = [2, 77], p = 0.044) and higher CDR Sum of Box scores (F = 3.20, df = [2, 77], p = 0.047) in the vitamin D-deficient group. There was no difference in performance on the MMSE, PPT, or factor scores between the vitamin D groups.

Conclusions

In a cross-section of older adults, vitamin D deficiency was associated with low mood and with impairment on two of four measures of cognitive performance.

Section snippets

Participants

This is a cross-sectional study of older adults participating in studies of cognitive and functional aging at the Alzheimer's Disease Research Center (ADRC) at Washington University. The ADRC recruits cognitively healthy and demented older adult participants from the greater metropolitan St. Louis, MO, area (population: 2.5 million). Participant recruitment occurs through public service announcements (radio, TV, and print media), requests to private physicians and organizations (e.g., the St.

RESULTS

The sample characteristics at the time of serum collection used for vitamin D determination are shown in Table 1. When the participants are divided into groups by vitamin D status (sufficient, insufficient, and deficient), differences were found in CDR Sum of Boxes, presence of active mood disorder, SBT scores, PPT scores, and age using analysis of variance (Table 2). No difference was found in MMSE, depressive features scores, or factor scores.

In the adjusted analyses (Table 3), vitamin D

DISCUSSION

In this study of older adults without significant functional disability, vitamin D deficiency was associated with low mood and worse performance on two measures of cognitive function. This study also found that 58% of the participants had vitamin D levels below the sufficient range. This finding is similar to prior reports of the prevalence of vitamin D deficiency older adults1, 6 but lower than a report by Sato et al. of vitamin D deficiency in persons with AD.7

Participants in this study with

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    This study was supported by grants from the National Institutes of Health: K12 HD01459 (CHW), P01 AG03991 (JCM), P50 AG05681 (JCM); and the Alan A. and Edith L. Wolff Charitable Trust (CHW/JCM).

    We thank Dr. Martha Storandt for providing the cognitive assessment data. We are also indebted to the Clinical and Genetics cores of the Alzheimer's Disease Research Center for providing the diagnostic data and serum used in this report.

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