Abstract
Objective
Vitamin D could prevent cognitive decline because of its neuroprotective, anti-inflammatory and antioxidant properties. This study aimed to evaluate the associations of plasma 25-hydroxyvitamin D (25(OH)D) concentrations with global cognitive function and incident dementia, including Alzheimer’s disease (AD).
Methods
The Canadian Study of Health and Aging is a 10-year cohort study of a representative sample of individuals aged 65 years or older. A total of 661 subjects initially without dementia with frozen blood samples and follow-up data were included. Global cognitive function was measured using the validated Modified Mini-Mental State (3MS) examination. A consensus diagnosis of all-cause dementia and AD was made between the physician and the neuropsychologist according to published criteria. Cognitive decline for a 5-year increase in age at specific 25(OH)D concentrations was obtained using linear mixed models with repeated measures. Hazard ratios of incident dementia and AD were obtained using semi-parametric proportional hazards models with age as time scale.
Results
Over a mean follow-up of 5.4 years, 141 subjects developed dementia of which 100 were AD. Overall, no significant association was found between 25(OH)D and cognitive decline, dementia or AD. Higher 25(OH)D concentrations were associated with an increased risk of dementia and AD in women, but not in men.
Conclusion
This study does not support a protective effect of vitamin D status on cognitive function. Further research is needed to clarify the relation by sex.
Résumé
Objectif
La vitamine D pourrait avoir un effet protecteur sur le déclin cognitif en raison de ses propriétés neuroprotectrices, anti-inflammatoires et antioxydantes. L’objectif de cette étude était d’évaluer les associations entre la concentration plasmatique de 25-hydroxyvitamine D (25(OH)D), la fonction cognitive globale et l’incidence de la démence incluant la maladie d’Alzheimer (MA).
Méthodes
L’Étude sur la santé et le vieillissement au Canada est une étude de cohorte de 10 ans réalisée dans un échantillon représentatif des Canadiens âgés de 65 ans et plus. Un total de 661 participants sans démence, pour lesquels un échantillon sanguin congelé et des données au suivi étaient disponibles, ont été inclus dans l’analyse. La fonction cognitive globale a été mesurée à l’aide d’un outil validé, le Modified Mini-Mental State (3MS) Examination. Les diagnostics de démence toutes causes et de MA ont été obtenus par consensus entre un médecin généraliste et un neuropsychologue selon des critères publiés. Le déclin cognitif pour chaque augmentation de 5 ans d’âge à des concentrations spécifiques de 25(OH)D a été mesuré à l’aide de modèles linéaires mixtes avec données répétées. Des rapports de risques de la démence et de la MA ont été obtenus à l’aide de modèles à risques proportionnels semi-paramétriques en utilisant l’âge comme échelle du temps.
Résultats
En cours de suivi (moyenne : 5,4 ans), 141 individus ont développé une démence dont 100 étaient la MA. Globalement, aucune association statistiquement significative n’a été observée entre le 25(OH)D et le déclin cognitif, la démence ou la MA. Des concentrations plus élevées de 25(OH)D étaient associées à une augmentation du risque de démence et de MA chez les femmes, mais pas chez les hommes.
Conclusion
Cette étude n’appuie pas l’hypothèse d’un effet protecteur de la vitamine D sur la fonction cognitive. D’autres études seraient nécessaires pour clarifier la relation selon le sexe.
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Acknowledgements
The authors want to thank the “Institut sur le vieillissement et la participation sociale des aînés” for providing financial support for the redaction of this manuscript. CSD was supported by a doctoral training award from the Fonds de recherche du Québec-Santé (FRQS) and the CIHR. DL and YG were supported by a scientist award from the FRQS.
Funding
This work was supported by the Canadian Institutes of Health Research (CIHR, grant number 133536).
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Duchaine, C.S., Talbot, D., Nafti, M. et al. Vitamin D status, cognitive decline and incident dementia: the Canadian Study of Health and Aging. Can J Public Health 111, 312–321 (2020). https://doi.org/10.17269/s41997-019-00290-5
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DOI: https://doi.org/10.17269/s41997-019-00290-5