School of Population and Global Health, University of Western Australia, Perth 6009, Australia.
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth 6009, Australia.
Int J Environ Res Public Health. 2021 Dec 31;19(1):450. doi: 10.3390/ijerph19010450.
Low vitamin D status has been linked to adverse cognitive outcomes in older adults. However, relationships at higher levels remain uncertain. We aimed to clarify patterns of association between vitamin D status and cognitive performance, using flexible regression methods, in 4872 middle- to older-aged adults (2678 females) from the Busselton Healthy Ageing Study. Cross-sectional associations of serum levels of 25-hydroxyvitamin D (25OHD) and performance in cognitive domains were modelled using linear regression and restricted cubic splines, controlling for demographic, lifestyle, and health factors. Mean ± SD serum 25OHD levels were 78 ± 24 nM/L for women and 85 ± 25 nM/L for men. Increasing levels in women were associated with better global cognition (linear trend, = 0.023) and attention accuracy (continuity of attention), with improvement in the latter plateauing around levels of 80 nM/L (nonlinear trend, = 0.035). In men, increasing levels of serum 25OHD were associated with better attention accuracy (linear trend, = 0.022), but poorer semantic verbal fluency (linear trend, = 0.025) and global cognition (nonlinear trend, = 0.015). We identified patterns of association between serum 25OHD levels and cognitive performance that may reflect early dose-response relationships, particularly in women. Longitudinal analyses extending through to older ages may help to clarify the nature, strength, and temporality of these relationships.
维生素 D 水平较低与老年人认知功能不良有关。然而，高水平的关系仍不确定。我们旨在使用灵活的回归方法，在来自比塞尔顿健康老龄化研究的 4872 名中年至老年成年人（2678 名女性）中阐明维生素 D 状态与认知表现之间的关联模式。使用线性回归和限制立方样条，控制人口统计学，生活方式和健康因素，对血清 25-羟维生素 D（25OHD）水平和认知域表现的横断面关联进行建模。女性的平均±SD 血清 25OHD 水平为 78±24 nM/L，男性为 85±25 nM/L。女性血清水平升高与整体认知能力提高呈正相关（线性趋势， = 0.023），注意力准确性（注意力连续性）也呈正相关，后者在 80 nM/L 左右趋于平稳（非线性趋势， = 0.035）。在男性中，血清 25OHD 水平升高与注意力准确性提高呈正相关（线性趋势， = 0.022），但语义语言流畅性（线性趋势， = 0.025）和整体认知能力下降（非线性趋势， = 0.015）。我们确定了血清 25OHD 水平与认知表现之间的关联模式，这些模式可能反映了早期的剂量反应关系，尤其是在女性中。扩展到老年的纵向分析可能有助于阐明这些关系的性质，强度和时间性。
