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Do the test results of cognitive function and activities of daily life of seniors correlate with the state of vitamin D supply to the organism?


Authors: Emmanuela Fernandová;  Hana Matějovská Kubešová
Authors‘ workplace: Klinika interní, geriatrie a praktického lékařství LF MU a FN Brno, pracoviště Bohunice
Published in: Vnitř Lék 2018; 64(11): 1107-1114
Category: Original Contributions

Overview

Introduction:

Till recently, the main effect of Vitamin D (calcitriol) was accounted for its role in regulation of calcium levels. But at the present time several other important functions of this vitamin have been unfolding in human organism, which currently ascribe to the properties of hormone. It also effects among other functions such as cognitive functions, immune system and muscle mass. In the resent past there are rising number of scientific publications on possible consequences of the long term deficit of Calcitriol, not only in the older generation. Aim: The aim of our study was to establish the relationship between the supply of Vitamin D to the organism and basic parameters of self-sufficiency, which are cognitive functions stipulated in the Mini Mental State Examination (MMSE) test and Barthels test for Activities of Daily Living (ADL) among seniors.

Materials and methods:

In our study we evaluated, 244 patients (65 men and 179 women) of average age 80,1 ± 7,4 (min. 65, max. 99) hospitalized at Department of Internal Medicine, Geriatrics, and General Practice of Faculty of Medicine, Masaryk University and Faculty Hospital Brno, from March 2012 to September 2012. The state of Vitamin D supply to the organism was evaluated with the help of serum Vitamin D total [1.25(OH)2D + 25(OH)D], the values of MMSE and ADL were taken from the third day of hospitalization till overcoming the acute stage. The characteristics of the patients were drawn with multimorbidity index CIRS – CI (cumulative Illness Rating Scale – Comorbidity Index). Furthermore, we observed the correlation of Serum Vitamin D levels to the season of the year.

Results: 

In our patients average concentration of vitamin D levels, MMSE, and ADL was 37.9 ± 26.1 (8–142 nmol/l), 23.36 ± 6.91 (0–30 points), 80.66 ± 25.13 (0–100 points), and CIRS CI 4.7 + 1.9 points, respectively. The correlation of vitamin D serum level with MMSE was r = 0,289 (p ≤ 0.01), with ADL r = 0,292 (p ≤ 0.01), and CIRS CI r = -0.22 (p < 0.05). Using multivariation analysis proved the significance of correlations obtained, even after the exclusion of multimorbidity. There was no statistically significant correlation between seasons of the year and serum vitamin D total level. However, nonsignificant decreasing trend of serum vitamin D total level with rising age of patients was found (r = -0.149, NS).

Conclusions:

The values obtained for MMSE and ADL demonstrated a significant correlation with serum vitamin D total levels. Attention paid to maintain an adequate supply of serum vitamin D in the organism, helps to maintain quality bone remodeling and functioning of other processes with which it takes part. For supplementing elderly sick patients, apart from diet, it is suitable to choose partially or fully hydroxylated supplements and adequate exposure to sunlight.

Key words: 

ADL – cognitive function – MMSE - vitamin D


Sources
  1. Kalvachová B. Endokrinní mikrosystémy kalcitriolu – vývojové aspekty a předpoklady jejich celoživotní funkčnosti. Vnitř Lék 2012; 58(5): 396–399.
  2. Zamrazil V. Význam vitaminu D – nové poznatky, které svědčí o jeho úloze v medicíně. Vnitř Lék 2012; 58(5): 379–380.
  3. Kulda V. Metabolizmus vitaminu D. Vnitř Lék 2012; 58(5): 400–404.
  4. Dietary suplement sheet. 2011. Vitamin D. Office of Dietary Supplements. National Institute of Health 2011; 2: 1–15. Dostupné z WWW: <https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h5>.
  5. Skalska A, Gałaś A, Grodzicki T. 25-hydroxyvitamin D and physical and cognitive performance in older people with chronic conditions. Pol Arch Med Wewn 2012; 122(4): 162–169.
  6. Marcelli C, Chavoix C, Dargent-Molina P. Beneficial effects of vitamin D on falls and fractures: is cognition rather than bone or muscle behind these benefits? Osteoporos Int 2015; 26(1): 1–10. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–014–2829–8>.
  7. Daly RM, Miller EG, Dunstan DW et al. The effects of progressive resistance training combined with a whey-protein drink and vitamin D supplementation on glycaemic control, body composition and cardiometabolic risk factors in older adults with type 2 diabetes: study protocol for a randomized controlled trial. Trials 2014; 15: 431. Dostupné z DOI: <http://dx.doi.org/10.1186/1745–6215–15–431>.
  8. Abelha-Aleixo J, Fonseca R, Bernardo A et al. Vitamin D – immunomodulatory actions and new potentialities. Acta Reumatol Port 2014; 39(4): 355–356.
  9. Matějovská Kubešová H, Tůmová J, Polcarová V et al. Vitamin D – připomínka známých a přehled méně známých skutečností. Vnitř Lék 2012; 58(3): 196–201.
  10. Sommer I, Griebler U, Kien C et al. Vitamin D deficiency as a risk factor for dementia: a systematic review and meta-analysis. BMC Geriatr 2017; 17(1): 16. Dostupné z DOI: <http://dx.doi.org/10.1186/s12877–016–0405–0>.
  11. Evatt ML, Delong MR, Khazai N et al. Prevalence of vitamin D insufficiency in patiens with Parkinson disease and Alzheimer disease. Arch Neurol 2008; 65(19): 1348–1352. Dostupné z DOI: <http://dx.doi.org/10.1001/archneur.65.10.1348>.
  12. Gezen-Ak D, Dursun E, Ertan T et al. Association between vitamin D receptor gene polymorphism and Alzheimer´s disease. Tohoku J Exp Med 2007; 212(3): 275–282.
  13. Andreeva VA, Whegang-Youdom S, Touvier M et al. Midlife dietary vitamin D intake and subsequent performance in different cognitive domains. Ann Nutr Metab 2014; 65(1): 81–89. Dostupné z DOI: <http://dx.doi.org/10.1159/000365154>.
  14. Balion C, Griffith LE, Strifler L et al. Vitamin D, cognition, and dementia: a systematic review and meta-analysis. Neurology 2012; 79(13): 1397–1405. Dostupné z DOI: <http://dx.doi.org/10.1212/WNL.0b013e31826c197f>.
  15. Wilson VK, Houston DK, Kilpatrick L et al. Relationship between 25-hydroxyvitamin D and cognitive function in older adults: the Health, Aging and Body Composition Study. J Am Geriatr Soc 2014; 62(4): 636–641. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.12765>.
  16. Milman S, Schulder-Katz M, Deluty J et al. Individuals with exceptional longevity manifest a delayed association between vitamin D insufficiency and cognitive impairment. J Am Geriatr Soc 2014; 62(1): 153–158. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.12601>.
  17. Chen RH, Zhao XH, Gu Z et al. Serum levels of 25-hydroxyvitamin D are associated with cognitive impairment in type 2 diabetic adults. Endocrine 2014; 45(2): 319–324. Dostupné z DOI: <http://dx.doi.org/10.1007/s12020–013–0041–9>.
  18. Mioshi E, Dawson K, Mitchell J et al. The Addenbrooke‘s Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry 2006; 21(11): 1078–1085. Dostupné z DOI: <http://dx.doi.org/10.1002/gps.1610>.
  19. Cranney A, Horsley T, O´Donnel S et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep) 2007; (158): 1–235.
  20. Morelli S, Buitrago C, Vasquez G et al. Involvement of tyrosine kinase activity in 1alpha,25(OH)2-vitamin D3 signal transduction in skeletal muscle cells. J Biol Chem 2000; 275(46): 36021–36028. Dostupné z DOI: <http://dx.doi.org/10.1074/jbc.M002025200>.
  21. Scott D, Blizzard L, Fell J et al. A prospective study of the associations between 25-hydroxy-vitamin D, sarcopenia progression and physical activity in older adults. Clin Endocrinol 2010; 73(5): 581–587. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2265.2010.03858.x>.
  22. Bauer JM, Kaiser MJ, Sieber CC. Sarcopenia in nursing home residents. J Am Med Dir Assoc 2008; 9(8): 545–551. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jamda.2008.04.010>.
  23. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9(3): 179–186.
  24. Folstein MF, Folstein SE, McHugh PR. „Mini-mental state“. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189–198.
  25. Mahoney FI, Barthel D. Functional evaluation: the Barthel Index. Md State Med J 1965; 14: 61–65.
  26. Salvi F, Miller MD, Grilli A et al. A manual of guidelines to score modified cumulative illness rating scale and its validation in acute hospitalized elderly patients. J Am Geriatr Soc 2008; 56(10): 1926–1931. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1532–5415.2008.01935.x>.
  27. Autier P, Boniol M, Pizot C et al. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol 2014; 2(1): 76–89. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(13)70165–7>.
  28. Tangpricha V, Pearce EN, Chen TC et al. Vitamin D insufficiency among free-living healthy young adults. Am J Med 2002; 112(8): 659–662.
  29. Bodekær M, Petersen B, Thieden E et al. UVR exposure and vitamin D in a rural population. A study of outdoor working farmers, their spouses and children. Photochem Photobiol Sci 2014; 13(11): 1598–1606. Dostupné z DOI: <http://dx.doi.org/10.1039/c4pp00188e>.
  30. Looker AC, Dawson-Hughes B, Calvo MS et al. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 2002; 30(5): 771–777.
  31. Vyskočil V. Vitamin D. Klin Farmakol Farm 2011; 25(2): 72–75.
  32. Šašinka M, Furková K. Vitamin D u starších ľudí. Geriatria 2012; 18(1): 21–28.
  33. Kalvach Z, Zadák Z, Jirák R et al. Geriatrie a gerontologie. Grada: Praha 2004. ISBN 80–247–0548–6.
  34. Brouwer-Brolsma EM, de Groot LC. Vitamin D and cognition in older adults: an update of recent findings. Curr Opin Clin Nutr Metab Care 2015; 18(1): 11–16. Dostupné z DOI: <http://dx.doi.org/10.1097/MCO.0000000000000114>.
  35. Granic A, Hill TR, Kirkwood TB et al. Serum 25-hydroxyvitamin D and cognitive decline in the very old: the Newcastle 85+ Study. Eur J Neurol 2015; 22(1): 106–115, e6–7. Dostupné z DOI: <http://dx.doi.org/10.1111/ene.12539>.
  36. Annweiler C, Brugg B, Peyrin JM et al. Combination of memantine and vitamin D prevents axon degeneration induced by amyloid-beta and glutamate. Neurobiol Aging 2014; 35(2): 331–335. Dostupné z DOI: <http://dx.doi.org/10.1016/j.neurobiolaging.2013.07.029>.
  37. van der Schaft J, Koek HL, Dijkstra E et al. The association between vitamin D and cognition: a systematic review. Ageing Res Rev 2013; 12(4): 1013–1023. Dostupné z DOI: <http://dx.doi.org/10.1016/j.arr.2013.05.004>.
  38. Chei CL, Raman P, Yin ZX et al. Vitamin D levels and cognition in elderly adults in China. J Am Geriatr Soc 2014; 62(11): 2125–2129. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.13082>.
  39. Goodwill AM, Szoeke C A. Systematic Review and Meta‐Analysis of The Effect of Low Vitamin D on Cognition. J Am Geriatr Soc 2017; 65(10): 2161–2168. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.15012>.
  40. Annweiler C, Dursun E, Féron F et al. „Vitamin D and cognition in older adults“: updated international recommendations. J Intern Med 2015; 277(1): 45–57. Dostupné z DOI: <http://dx.doi.org/10.1111/joim.12279>.
  41. Viveky N, Toffelmire L, Thorpe L et al. Use of vitamin and mineral supplements in long-term care home residents. Appl Physiol Nutr Metab 2012; 37(1): 100–105. Dostupné z DOI: <http://dx.doi.org/10.1139/h11–141>.
  42. Alfred T, Ben-Shlomo Y, Cooper R et al. Genetic variants influencing biomarkers of nutrition are not associated with cognitive capability in middle-aged and older adults. J Nutr 2013; 143(5): 606–612. Dostupné z DOI: <http://dx.doi.org/10.3945/jn.112.171520>.
  43. Lu‘o‘ng KV, Nguyen LT. The role of vitamin D in Alzheimer‘s disease: possible genetic and cell signaling mechanisms. Am J Alzheimers Dis Other Demen 2013; 28(2): 126–136. Dostupné z DOI: <http://dx.doi.org/10.1177/1533317512473196>.
  44. Lucock M, Yates Z, Martin C et al. Vitamin D, folate, and potential early lifecycle environmental origin of significant adult phenotypes. Evol Med Public Health 2014; 2014(1): 69–91. Dostupné z DOI: <http://dx.doi.org/10.1093/emph/eou013>.
  45. Glocke M, Lang F, Schaeffeler E et al. Impact of vitamin D receptor VDR rs2228570 polymorphism in oldest old. Kidney Blood Press Res 2013; 37(4–5): 311–322. Dostupné z DOI: <http://dx.doi.org/10.1159/000350159>.
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Diabetology Endocrinology Internal medicine

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