Relationship Between 25-Hydroxyvitamin D and Cognitive Function in Older Adults:
The Health, Aging and Body Composition Study
The American Geriatrics Society DOI: 10.1111/jgs.12765, Article first published online: 17 MAR 2014
Valerie K. Wilson MD1,*, Denise K. Houston PhD1, Laurel Kilpatrick MD2, James Lovato MS3, Kristine Yaffe MD4,5,6, Jane A. Cauley DrPH7, Tamara B. Harris MD, MS8, Eleanor M. Simonsick PhD9, Hilsa N. Ayonayon PhD6, Stephen B. Kritchevsky PhD1, Kaycee M. Sink MD, MAS1 andfor the Health, Aging and Body Composition Study
1Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina
2Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama
3Department of Biostatistics, Wake Forest School of Medicine, Winston Salem, North Carolina
4Department of Psychiatry, University of California at San Francisco, San Francisco, California
5Department of Neurology, University of California at San Francisco, San Francisco, California
6Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California
7Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
8Intramural Research Program, National Institute on Aging, Bethesda, Maryland
9Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
*Address correspondence to Valerie K. Wilson, Sticht Center on Aging, Medical Center Blvd, Winston-Salem, NC 27157. E-mail: vwilson at wakehealth.edu
Objectives: To examine the relationship between 25-hydroxyvitamin D (25(OH)D) levels and cognitive performance over time in older adults in the Health, Aging and Body Composition (Health ABC) Study.
Design: Prospective cohort study.
Setting: Community-dwelling participants in Pittsburgh, Pennsylvania, and Memphis, Tennessee.
Participants
Well-functioning adults aged 70 to 79 at baseline with serum 25(OH)D measured at the 12-month follow-up visit and cognitive function measured at baseline and 4-year follow-up visit (N = 2,777).
Measurements: Vitamin D status was categorized as 25(OH)D levels of less than 20.0 ng/mL, 20.0 to 29.9 ng/mL, or 30.0 ng/mL or greater. Cognition was measured using the modified Mini-Mental State Examination (3MS) and Digit Symbol Substitution Test (DSST). Linear regression models adjusting for multiple covariates, including age, education, sex, race, site, season, physical activity, and comorbidities, were used in the analysis.
Results: Sixty-eight percent of participants had 25(OH)D levels of less than 30.0 ng/mL. Lower 25(OH)D levels were associated with lower baseline cognitive scores on the 3MS (adjusted mean 89.9, 95% confidence interval (CI) = 89.4–90.4 for <20.0 ng/mL; adjusted mean 90.8, 95% CI = 90.4–91.3 for 20.0–29.9 ng/mL; adjusted mean 90.6, 95% CI = 90.2–91.1 for ≥30.0 ng/mL; P trend = .02) and the DSST (adjusted mean 35.2, 95% CI = 34.5–36.0 for <20.0 ng/mL; adjusted mean 35.9, 95% CI = 35.2–36.6 for 20.0–29.9 ng/mL; adjusted mean 37.0, 95% CI = 36.3–37.8 for ≥30.0 ng/mL; P trend = .01).
Participants with low 25(OH)D levels had greater declines in 3MS scores over 4 years than those with higher levels (least square mean change −1.0, 95% CI = −1.5 to −0.6 for <20.0 ng/mL; least square mean change −0.8, 95% CI = −1.2 to −0.3 for 20.0–29.9 ng/mL; least square mean change −0.2, 95% CI = −0.7 to 0.2 for ≥30.0 ng/mL; P = .05). There was no significant difference in DSST decline according to 25(OH)D level.
Conclusion: Low 25(OH)D levels were associated with worse global cognitive function and greater decline over time aiccording to the 3MS. Intervention trials are needed to determine whether vitamin D supplementation can reduce cognitive decline.
Vitamin D Life bought a copy of the study ($3.50), but cannot place it in the public web
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