Wilkins Consuelo H, Sheline Yvette I, Roe Catherine M, Birge Stanley J, Morris John C
Department of Medicine, Division of Geriatrics and Nutritional Science, Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO 63108, USA.
Am J Geriatr Psychiatry. 2006 Dec;14(12):1032-40. doi: 10.1097/01.JGP.0000240986.74642.7c.
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.
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.
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 chi(2) = 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.
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.
维生素D缺乏在老年人中很常见,并且与精神和神经疾病有关。本研究调查了老年人维生素D状态、认知表现、情绪和身体表现之间的关系。
从一项记忆与衰老的纵向研究中选取了80名参与者组成一个横断面研究组,其中40名患有轻度阿尔茨海默病(AD),40名无痴呆症。使用简短Blessed测试(SBT)、简易精神状态检查(MMSE)、临床痴呆评定量表(CDR;方框总分越高表明痴呆严重程度越高)以及神经心理测验电池的因子得分来评估认知功能;使用临床医生诊断和抑郁症状量表来评估情绪。使用身体表现测试(PPT)来测量功能状态。对所有参与者测量血清25-羟维生素D水平。
总样本中维生素D的平均水平为18.58 ng/mL(标准差:7.59);58%的参与者维生素D水平异常低,定义为低于20 ng/mL。在调整年龄、种族、性别和维生素D测定季节后,维生素D缺乏与存在活跃情绪障碍相关(优势比:11.69,95%置信区间:2.04 - 66.86;Wald卡方(2)=7.66,自由度=2,p = 0.022)。在一个线性回归模型中使用相同的协变量,维生素D缺乏与维生素D缺乏组在SBT上表现较差(F = 5.22,自由度=[2, 77],p = 0.044)以及较高的CDR方框总分得分(F = 3.20,自由度=[2, 77],p = 0.047)相关。维生素D组在MMSE、PPT或因子得分方面的表现没有差异。
在一组老年人横断面研究中,维生素D缺乏与情绪低落以及四项认知表现测量中的两项受损有关。