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Effect of vitamin D on cognitive function and white matter hyperintensity in patients with mild Alzheimer's disease
En-Jie Shih1,2, Wei-Ju Lee2,3,4,5,6, Jung-Lung Hsu7,8,9
1Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Aim:
To examine the effect of vitamin D level on cognitive function and white matter hyperintensity (WMH) in patients with mild Alzheimer's disease (AD).
Methods:
We recruited patients with mild AD, and carried out clinical interviews, neuropsychological assessments, laboratory tests and brain magnetic resonance imaging.
Results:
In total, 146 patients with mild AD (68 men, 78 women; mean age 79.1 ± 7.0 years; mean education 10.2 ± 4.3 years) were enlisted. The mean Mini-Mental State Examination (MMSE) score was 21.0 ± 3.8. The 25-hydroxy vitamin D (25[OH]D) level was correlated negatively with the WMH volume (β = -0.219, P = 0.004) after adjusting for age, sex, years of education, apolipoprotein ε4 allele status, seasons of blood sampling, hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease and total brain volume. The 25(OH)D level was correlated positively with the MMSE score (β = 0.309, P < 0.001) after adjusting for the same covariates. Multivariate regression analysis with the MMSE score serving as the dependent variable and adjustment for covariates showed that the 25(OH)D level was an independent predictor of the MMSE score (β = 0.322, P < 0.001), but the WMH volume was not (β = 0.056, P = 0.587). These findings suggest that WMH has no mediation effect between the 25(OH)D level and the MMSE score.
Conclusions:
Reduced plasma 25(OH)D levels were associated with low MMSE scores in patients with mild AD, but the underlying mechanism is not attributable to WMH. Thus, it suggested that the presence of another pathomechanism exists. Geriatr Gerontol Int 2020; 20: 52-58.
Insights
Vitamin D levels are linked to cognitive function in mild Alzheimer's disease (AD). Lower vitamin D is associated with lower cognitive scores, but not explained by white matter hyperintensities (WMH).
Area of Science:
- Neurology
- Gerontology
- Nutritional Science
Background:
- Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
- Cognitive decline and white matter hyperintensities (WMH) are common in mild AD.
- The role of vitamin D in AD pathogenesis is an area of ongoing research.
Purpose of the Study:
- To investigate the association between vitamin D levels and cognitive function in patients with mild AD.
- To determine if white matter hyperintensities (WMH) mediate the relationship between vitamin D and cognitive function in mild AD.
Main Methods:
- Recruitment of patients diagnosed with mild Alzheimer's disease.
- Conducting clinical interviews, comprehensive neuropsychological assessments, and laboratory tests.
- Utilizing brain magnetic resonance imaging (MRI) to evaluate white matter hyperintensities (WMH).
Main Results:
- A cohort of 146 patients with mild AD (mean age 79.1 years) was analyzed.
- Lower 25-hydroxy vitamin D (25[OH]D) levels correlated with increased WMH volume (P=0.004).
- Higher 25[OH]D levels were independently associated with better cognitive function, as measured by the Mini-Mental State Examination (MMSE) score (P<0.001).
Conclusions:
- Reduced plasma 25(OH)D levels are associated with lower cognitive function (MMSE scores) in mild AD.
- White matter hyperintensities (WMH) do not appear to mediate this relationship.
- The findings suggest an alternative pathomechanism linking vitamin D to cognitive function in AD, distinct from WMH.
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