Kiderman David, Ben-Shabat Niv, Tsur Avishai M, Anis Saar, Watad Abdulla, Cohen Arnon D, Paz Ziv, Amital Howard
Hadassah Faculty of Medicine, The Hebrew University, Jerusalem, Israel.
Kaplan Medical Center, Rehovot, Israel.
J Geriatr Psychiatry Neurol. 2023 Nov;36(6):511-518. doi: 10.1177/08919887231163292. Epub 2023 Mar 8.
Active metabolite of vitamin D has neuro-immunomodulatory and neuroprotective properties. However, there is still a debate about the potential association between low serum levels of hydroxy-vitamin D and increased risk for dementia.
To determine an association between hypovitaminosis D and dementia for different 25-hydroxyvitamin-D (25(OH)D) serum level cutoffs.
Patients were identified utilizing the database of Clalit Health Services (CHS), the largest healthcare provider in Israel. For each subject, all available values of 25(OH)D during the study period, which lasted from 2002 to 2019, were obtained. Rates of dementia were compared across different cutoffs of 25(OH)D levels.
Cohort included 4278 patients, of whom 2454 (57%) were women. The mean age at the beginning of follow-up was 53 (±17). During the 17-year study period, a total of 133 patients (3%) were diagnosed with dementia. In a fully adjusted multivariate analysis, the risk for dementia was almost 2-fold higher in patients with an average of vitamin D insufficiency (<75 nmol/l) measurements (OR = 1.8, 95% C.I. = 1.0-3.2) compared to reference values (≥75 nmol/l). Patients with vitamin D deficiency (<50 nmol/l) demonstrated higher rates of dementia (OR = 2.6, 95% C.I. = 1.4-4.8). In our cohort, patients were diagnosed with dementia at a younger age in the deficiency (77 vs. 81 -value = 0.05) and the insufficiency groups (77 vs. 81 -value = 0.05) compared to the reference values (≥75 nmol/l).
Insufficient levels of vitamin D are associated with dementia. Dementia is diagnosed at a younger age in patients with insufficient and deficient vitamin D levels.
维生素D的活性代谢产物具有神经免疫调节和神经保护特性。然而，血清羟基维生素D水平低与痴呆风险增加之间的潜在关联仍存在争议。
确定不同25-羟基维生素D（25(OH)D）血清水平临界值时维生素D缺乏与痴呆之间的关联。
利用以色列最大的医疗服务提供商克拉利特医疗服务公司（Clalit Health Services，CHS）的数据库识别患者。对于每个受试者，获取了2002年至2019年研究期间所有可用的25(OH)D值。比较了不同25(OH)D水平临界值下的痴呆发生率。
队列包括4278名患者，其中2454名（57%）为女性。随访开始时的平均年龄为53岁（±17岁）。在17年的研究期间，共有133名患者（3%）被诊断为痴呆。在一项完全调整的多变量分析中，平均维生素D不足（<75 nmol/l）测量值的患者患痴呆的风险几乎是参考值（≥75 nmol/l）患者的2倍（OR = 1.8，95%置信区间 = 1.0 - 3.2）。维生素D缺乏（<50 nmol/l）的患者痴呆发生率更高（OR = 2.6，95%置信区间 = 1.4 - 4.8）。在我们的队列中，与参考值（≥75 nmol/l）相比，缺乏组（77岁对81岁 - p值 = 0.05）和不足组（77岁对81岁 - p值 = 0.05）的患者被诊断为痴呆的年龄更小。
维生素D水平不足与痴呆有关。维生素D水平不足和缺乏的患者被诊断为痴呆的年龄更小。
