Perna Laura, Mons Ute, Kliegel Matthias, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Dement Geriatr Cogn Disord. 2014;38(3-4):254-63. doi: 10.1159/000362870. Epub 2014 Jun 25.
BACKGROUND/AIMS: Very few studies have investigated the longitudinal association between serum levels of 25-hydroxyvitamin D [25(OH)D] and cognitive impairment not due to dementia. This longitudinal study analysed 25(OH)D and the risk of cognitive decline among non-demented older adults.
A subsample of the ESTHER cohort study, aged ≥70 years, was assessed with the Cognitive Telephone Screening Instrument (COGTEL) and underwent 25(OH)D measurements standardized with a reference method (n = 1,302). After an average follow-up of 4.6 years, 527 participants had repeated COGTEL testing and were eligible for analysis. Linear regression models were used to assess longitudinal associations between 25(OH)D levels and cognitive function. Possible practice effects of repeated cognitive testing were addressed with the reliable change index.
A trend of a more pronounced cognitive decline with lower vitamin D levels was observed among both women and men, with a statistically significant difference in COGTEL scores in the lowest vitamin D quintile of the total sample.
This study indicates that low levels of vitamin D might be associated with cognitive decline among non-demented elderly individuals and highlights the need for further large-scale prospective studies to clarify the potential role of vitamin D in cognitive function at an old age.
背景/目的：很少有研究调查血清25-羟基维生素D[25(OH)D]水平与非痴呆性认知障碍之间的纵向关联。这项纵向研究分析了非痴呆老年人的25(OH)D水平与认知衰退风险。
对ESTHER队列研究中年龄≥70岁的一个子样本，使用认知电话筛查工具(COGTEL)进行评估，并采用参考方法对25(OH)D进行标准化测量（n = 1302）。在平均随访4.6年后，527名参与者重复进行了COGTEL测试并符合分析条件。使用线性回归模型评估25(OH)D水平与认知功能之间的纵向关联。通过可靠变化指数解决重复认知测试可能产生的练习效应。
在男性和女性中均观察到维生素D水平越低，认知衰退越明显的趋势，在总样本中维生素D最低五分位数组的COGTEL得分存在统计学显著差异。
本研究表明，低水平维生素D可能与非痴呆老年人的认知衰退有关，并强调需要进一步开展大规模前瞻性研究，以阐明维生素D在老年人认知功能中的潜在作用。
