Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA.
Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Sci Rep. 2021 Dec 1;11(1):23253. doi: 10.1038/s41598-021-02485-8.
Low vitamin D levels have been associated with cognitive decline; however, few randomized trials have been conducted. In a trial, we evaluated vitamin D3 supplementation on cognitive decline. We included participants aged 60+ years (mean[SD] = 70.9[5.8] years) free of cardiovascular disease and cancer in two substudies in the VITAL 2 × 2 randomized trial of vitamin D3 (2000 IU/day of cholecalciferol) and fish oil supplements: 3424 had cognitive assessments by phone (eight neuropsychologic tests; 2.8 years follow-up) and 794 had in-person assessments (nine tests; 2.0 years follow-up). The primary, pre-specified outcome was decline over two assessments in global composite score (average z-scores of all tests); substudy-specific results were meta-analyzed. The pooled mean difference in annual rate of decline (MD) for vitamin D3 versus placebo was 0.01 (95% CI - 0.01, 0.02; p = 0.39). We observed no interaction with baseline 25-hydroxyvitamin-D levels (p-interaction = 0.84) and a significant interaction with self-reported race (p-interaction = 0.01). Among Black participants (19%), those assigned vitamin D3 versus placebo had better cognitive maintenance (MD = 0.04, 95% CI 0.01, 0.08, similar to that observed for Black participants 1.2 years apart in age). Thus, vitamin D3 (2000 IU/day cholecalciferol) supplementation was not associated with cognitive decline over 2-3 years among community-dwelling older participants but may provide modest cognitive benefits in older Black adults, although these results need confirmation.Trial registration ClinicalTrials.gov; VITAL (NCT01169259), VITAL-DEP (NCT01696435) and VITAL-Cog (NCT01669915); the date the registration for the parent trial (NCT01169259) was submitted to the registry: 7/26/2010 and the date of first patient enrollment in either of the ancillary studies for cognitive function in a subset of eligible VITAL participants: 9/14/2011.
维生素 D 水平较低与认知能力下降有关；然而，很少有随机试验进行。在一项试验中，我们评估了维生素 D3 补充剂对认知能力下降的影响。我们纳入了 VITAL 2×2 随机试验维生素 D3（2000IU/天胆钙化醇）和鱼油补充剂的两个亚研究中无心血管疾病和癌症的 60 岁以上参与者（平均[SD]年龄=70.9[5.8]岁）：3424 人通过电话进行认知评估（八项神经心理测试；随访 2.8 年），794 人进行了面对面评估（九项测试；随访 2.0 年）。主要的、预先指定的结果是两次评估中全球综合评分的下降（所有测试的平均 z 评分）；亚研究的特定结果进行了荟萃分析。与安慰剂相比，维生素 D3 的年下降率（MD）平均差异为 0.01（95%CI-0.01，0.02；p=0.39）。我们没有观察到与基线 25-羟维生素 D 水平的交互作用（p 交互作用=0.84），但与自我报告的种族有显著的交互作用（p 交互作用=0.01）。在黑人参与者（19%）中，与安慰剂相比，接受维生素 D3 治疗的参与者认知功能维持更好（MD=0.04，95%CI 0.01，0.08，与年龄相差 1.2 年的黑人参与者观察到的结果相似）。因此，在社区居住的老年参与者中，补充维生素 D3（2000IU/天胆钙化醇）与 2-3 年内的认知能力下降无关，但可能为老年黑人成年人提供适度的认知益处，尽管这些结果需要进一步证实。
试验注册临床Trials.gov；VITAL（NCT01169259），VITAL-DEP（NCT01696435）和 VITAL-Cog（NCT01669915）；该试验（NCT01169259）向登记处提交注册的日期为 2010 年 7 月 26 日，在 VITAL 参与者的一个亚组中进行认知功能的辅助研究之一开始招募参与者的日期为 2011 年 9 月 14 日。
