Vitamin D, cognition, and dementia
A systematic review and meta-analysis
Abstract
Objective:
To examine the association between cognitive function and dementia with vitamin D concentration in adults.
Methods:
Five databases were searched for English-language studies up to August 2010, and included all study designs with a comparative group. Cognitive function or impairment was defined by tests of global or domain-specific cognitive performance and dementia was diagnosed according to recognized criteria. A vitamin D measurement was required. Two authors independently extracted data and assessed study quality using predefined criteria. The Q statistic and I2 methods were used to test for heterogeneity. We conducted meta-analyses using random effects models for the weighted mean difference (WMD) and Hedge's g.
Results:
Thirty-seven studies were included; 8 contained data allowing mean Mini-Mental State Examination (MMSE) scores to be compared between participants with vitamin D <50 nmol/L to those with values ≥50 nmol/L. There was significant heterogeneity among the studies that compared the WMD for MMSE but an overall positive effect for the higher vitamin D group (1.2, 95% confidence interval [CI] 0.5 to 1.9; I2 = 0.65; p = 0.002). The small positive effect persisted despite several sensitivity analyses. Six studies presented data comparing Alzheimer disease (AD) to controls but 2 utilized a method withdrawn from commercial use. For the remaining 4 studies the AD group had a lower vitamin D concentration compared to the control group (WMD = −6.2 nmol/L, 95% CI −10.6 to −1.8) with no heterogeneity (I2 < 0.01; p = 0.53).
Conclusion:
These results suggest that lower vitamin D concentrations are associated with poorer cognitive function and a higher risk of AD. Further studies are required to determine the significance and potential public health benefit of this association.
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Information & Authors
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Copyright © 2012 by AAN Enterprises, Inc.
Publication History
Received: August 11, 2011
Accepted: May 1, 2012
Published online: September 24, 2012
Published in print: September 25, 2012
Disclosure
C. Balion receives research support from the Canadian Institutes of Health Research, the Agency for Healthcare Research and Quality, the Canada Foundation for Innovation (CFI), and the Ontario Ministry of Health and Long-Term Care. L. Griffith receives research support from the Canadian Institutes of Health Research, Agency for Healthcare Research and Quality, and Ontario Ministry of Long-Term Care. L. Strifler has received funding from the Ontario Ministry of Long-Term Care. M. Henderson has received funding from the Ontario Ministry of Long-Term Care. C. Patterson has received funding from the Ontario Ministry of Long-Term Care. G. Heckman has received consultant fees from Novartis and Janssen-Ortho for participation in advisory boards related to cholinesterase inhibitors. He is also funded through the Schlegel Research Chair in Geriatric Medicine at the University of Waterloo and has received funding from the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, and Ontario Ministry of Health and Long-Term Care. D. Llewellyn has received funding from the Nutrition Society and American Society of Nutrition for conference travel and has grants funded by the James Tudor Foundation, the Sir Halley Stewart Trust, the Norman Family Charitable Trust, the Peninsula Medical School Foundation, and the Age Related Diseases and Health Trust. P. Raina receives research support from the Canadian Institutes of Health Research, Agency for Healthcare Research and Quality, Ontario Ministry of Health and Long-Term Care, and Canada Foundation for Innovation. Go to Neurology.org for full disclosures.
Authors
Author Contributions
Dr. Balion: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, acquisition of data, statistical analysis, study supervision, obtaining funding. Dr. Griffith: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, acquisition of data, study supervision. Ms. Strifler: drafting/revising the manuscript, analysis or interpretation of data, acquisition of data. Dr. Henderson: drafting/revising the manuscript, analysis or interpretation of data, acquisition of data. Dr. Patterson: drafting/revising the manuscript. Dr. Heckman: drafting/revising the manuscript. Dr. Llewellyn: drafting/revising the manuscript, interpretation of the data. Dr. Raina: drafting/revising the manuscript, study supervision.
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