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探索智利老年人维生素D与认知功能变化之间的关联:来自ALEXANDROS队列研究的证据。

Exploring the Association between Vitamin D and Changes in Cognitive Function in Chilean Older Adults: Evidence from the ALEXANDROS Cohort Study.

作者信息

Márquez Carlos, Angel Bárbara, Lera Lydia, Bendayan Rebecca, Sánchez Hugo, Albala Cecilia

机构信息

Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago 7830490, Chile.

Latin Division, Keiser University eCampus, Fort Lauderdale, FL 33409, USA.

出版信息

J Pers Med. 2022 Jun 30;12(7):1078. doi: 10.3390/jpm12071078.

Abstract

Background: The increasing aging of the population with the consequent increase of age-associated cognitive disorders pose the challenge of controlling its preventable risk factors, among which vitamin D deficit is a putative factor. Thus, our objective is to explore the association between vitamin D and cognitive performance in a cohort study of community-dwelling Chilean older people. Material and Methods: Cohort study of 955 (69.7% female), community-dwelling older Chileans free of cognitive impairment from the Alexandros cohorts, with 25(OH)D measurement at baseline. Cognitive Function was evaluated with the Mini Mental State Examination (MMSE) short-form questionnaire. Plasma levels of 25(OH)D were classified as Normal > 30 ng/mL Insufficiency 20−29 ng/mL, Deficiency 20−12 ng/mL and Severe Deficiency < 12 ng/mL. Penalized regressions models were made to assess associations. Results: Mean age of the sample was 66.6 + 4.5 years, with 8.5 + 4.7 years of education. After a mean follow-up of 9.6 years, 54 new cases of Mild Cognitive Impairment (MCI)were identified (Incidence density rate = 5.9 per 1000 person/years). Mean vitamin D plasma levels were lower in people with MCI than in the normal cognitive ones (23.0 + 12.75 vs. 28.35 + 15.17 ng/mL, p < 0.01). In the fully adjusted model only severe deficiency of vitamin D was associated with MCI (RR = 2.33; 95% CI: (1.03−5.26). Conclusions: In this longitudinal study, our results confirm that low Vitamin D is a risk factor for MCI, and that people with severe deficiency have more than double the risk of MCI people with normal Vitamin D levels. Considering the high frequency of vitamin D deficiency in older people, and its preventability, these results are very valuable for future public health programmes.

摘要

背景

随着人口老龄化加剧,与年龄相关的认知障碍增多,这对控制其可预防的风险因素构成了挑战,其中维生素D缺乏是一个假定因素。因此,我们的目标是在一项针对智利社区老年人的队列研究中探索维生素D与认知表现之间的关联。

材料与方法

对来自亚历山德罗斯队列的955名(69.7%为女性)无认知障碍的智利社区老年人进行队列研究,在基线时测量25(OH)D。使用简易精神状态检查表(MMSE)简表问卷评估认知功能。血浆25(OH)D水平分类为:正常>30 ng/mL、不足20 - 29 ng/mL、缺乏20 - 12 ng/mL和严重缺乏<12 ng/mL。采用惩罚回归模型评估关联。

结果

样本的平均年龄为66.6 ± 4.5岁,受教育年限为8.5 ± 4.7年。平均随访9.6年后,识别出54例轻度认知障碍(MCI)新病例(发病率密度率 = 每1000人年5.9例)。MCI患者的平均维生素D血浆水平低于认知正常者(23.0 ± 12.75 vs. 28.35 ± 15.17 ng/mL,p < 0.01)。在完全调整模型中,仅维生素D严重缺乏与MCI相关(RR = 2.33;95% CI:(1.03 - 5.26))。

结论

在这项纵向研究中,我们的结果证实低维生素D是MCI的一个风险因素,严重缺乏者患MCI的风险是维生素D水平正常者的两倍多。鉴于老年人维生素D缺乏的高发生率及其可预防性,这些结果对未来的公共卫生计划非常有价值。

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