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25-羟维生素 D 水平与老年男性的认知表现和下降。

25-Hydroxyvitamin D levels and cognitive performance and decline in elderly men.

机构信息

One Veterans Dr. (111J), Minneapolis, MN 55417, USA.

出版信息

Neurology. 2010 Jan 5;74(1):33-41. doi: 10.1212/WNL.0b013e3181c7197b. Epub 2009 Nov 25.

Abstract

OBJECTIVE

To test the hypothesis that lower 25-hydroxyvitamin D [25(OH)D] levels are associated with a greater likelihood of cognitive impairment and risk of cognitive decline.

METHODS

We measured 25(OH)D and assessed cognitive function using the Modified Mini-Mental State Examination (3MS) and Trail Making Test Part B (Trails B) in a cohort of 1,604 men enrolled in the Osteoporotic Fractures in Men Study and followed them for an average of 4.6 years for changes in cognitive function.

RESULTS

In a model adjusted for age, season, and site, men with lower 25(OH)D levels seemed to have a higher odds of cognitive impairment, but the test for trend did not reach significance (impairment by 3MS: odds ratio [OR] 1.84, 95% confidence interval [CI] 0.81-4.19 for quartile [Q] 1; 1.41, 0.61-3.28 for Q2; and 1.18, 0.50-2.81 for Q3, compared with Q4 [referent group; p trend = 0.12]; and impairment by Trails B: OR 1.66, 95% CI 0.98-2.82 for Q1; 0.96, 0.54-1.69 for Q2; and 1.30, 0.76-2.22 for Q3, compared with Q4 [p trend = 0.12]). Adjustment for age and education further attenuated the relationships. There was a trend for an independent association between lower 25(OH)D levels and odds of cognitive decline by 3MS performance (multivariable OR 1.41, 95% CI 0.89-2.23 for Q1; 1.28, 0.84-1.95 for Q2; and 1.06, 0.70-1.62 for Q3, compared with Q4 [p = 0.10]), but no association with cognitive decline by Trails B.

CONCLUSION

We found little evidence of independent associations between lower 25-hydroxyvitamin D level and baseline global and executive cognitive function or incident cognitive decline.

摘要

目的

验证假设,即较低的 25-羟维生素 D [25(OH)D] 水平与认知障碍的可能性增加和认知能力下降的风险相关。

方法

我们在参加男性骨质疏松性骨折研究的 1604 名男性中测量了 25(OH)D,并使用改良的简易精神状态检查(3MS)和连线测试 B 部分(Trails B)评估了认知功能,并在平均 4.6 年内对认知功能的变化进行了随访。

结果

在调整年龄、季节和地点的模型中,25(OH)D 水平较低的男性似乎更有可能出现认知障碍,但趋势检验未达到显著水平(3MS 障碍:比值比 [OR] 1.84,95%置信区间 [CI] 0.81-4.19 为四分位 [Q] 1;1.41,0.61-3.28 为 Q2;1.18,0.50-2.81 为 Q3,与 Q4[参照组]相比;p 趋势=0.12);Trails B 障碍:OR 1.66,95%CI 0.98-2.82 为 Q1;0.96,0.54-1.69 为 Q2;1.30,0.76-2.22 为 Q3,与 Q4 相比[p 趋势=0.12])。进一步调整年龄和教育程度会减弱这些关系。25(OH)D 水平与 3MS 表现的认知下降几率之间存在独立关联的趋势(多变量 OR 1.41,95%CI 0.89-2.23 为 Q1;1.28,0.84-1.95 为 Q2;1.06,0.70-1.62 为 Q3,与 Q4 相比[p=0.10]),但与 Trails B 认知下降无关。

结论

我们发现,25-羟维生素 D 水平较低与基线整体和执行认知功能或认知能力下降发生率之间几乎没有独立关联的证据。

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