Serum vitamin D in patients with mild cognitive impairment and Alzheimer's disease

Abstract

ObjectivesTo determine the relevance of Mini‐Mental State Examination (MMSE), serum 25‐hydroxyvitamin D (25(OH)D3), and 1,25(OH)2D3 concentrations to mild cognitive impairment (MCI) and various stages of Alzheimer's disease (AD).Materials and MethodsThe study included 230 participants (>74 years) allocated to three main groups: 1‐healthy subjects (HS, n = 61), 2‐patients with MCI (n = 61), and 3‐ patients with Alzheimer's disease (AD) subdivided into three stages: mild (n = 41), moderate (n = 35), and severe AD (n = 32). The cognitive status was evaluated using MMSE. Serum 25 (OH)D3 (ng/ml) and 1,25(OH)2D3 concentrations (pg/ml) were determined by competitive radioimmunoassay.Results MMSE scores and 25(OH)D3 were decreased in MCI and all stages of the AD in both genders. MMSE variability was due to gender in HS (11%) and to 25(OH)D3 in MCI (15%) and AD (26%). ROC analysis revealed an outstanding property of MMSE in diagnosis of MCI (AUC, 0.906; CI 95%, 0.847–0.965; sensitivity 82%; specificity, 98%) and AD (AUC, 0.997; CI 95%, 0.992–1; sensitivity, 100%; specificity, 98%). 25(OH)D3 exhibited good property in MCI (AUC, 0.765; CI 95%, 0.681–0.849; sensitivity, 90%; specificity, 54%) and an excellent property in diagnosis of AD (AUC, 0.843; CI 95%, 0.782–0.904; sensitivity, 97%; specificity, 79%). Logistic analyses revealed that, in MCI, MMSE could predict (or classify correctly) with 97.6% accuracy (Wald, 15.22, β, −0.162; SE, 0.554; OR = 0.115:0.039–0.341; p = .0001), whereas 25(OH)D3 with 80% accuracy (Wald, 41,013; β, −0.213; SE, 0.033; OR = 0.808: 0.757–863; p = .0001). 25(OH)D3 was the only significant predictor for the severe AD and contributed to MMSE variability. Age and gender were significant predictors only in the moderate AD. In patients with MCI, 25(OH)D3 and 1,25(OH)2D3 were correlated men, but in case of the AD, they were correlated in women.Conclusions MMSE and serum 25(OH)D3 concentrations could be useful biomarkers for prediction and diagnosis of MCI and various stages of the AD. The results support the utility of vitamin D supplementation in AD therapy regimen.

Vitamin D deficiency is associated with reduced hippocampal volume and disrupted structural connectivity in patients with mild cognitive impairment

“…Our result is consistent with a large volume of published studies that have found an association between MMSE score and serum vitamin D (Balion et al, 2012;Matchar et al, 2016;Vedak et al, 2015). A recent study purports the combination of MMSE score with serum 25-OHD could have a predictive value of 98% in diagnosing MCI and AD (Ouma et al, 2018). Similarly, in elderly MCI patients, hippocampal atrophy is predictive of progression to AD (Jack Jr. et al, 1999).…”

“…In this study, there were significant differences in all cognitive scales (MMSE, CDR, CDR-SOB, and GDS) except the GDepS between the vitamin D-deficient and not-deficient groups. A recent study purports the combination of MMSE score with serum 25-OHD could have a predictive value of 98% in diagnosing MCI and AD (Ouma et al, 2018). A recent study purports the combination of MMSE score with serum 25-OHD could have a predictive value of 98% in diagnosing MCI and AD (Ouma et al, 2018).…”

Cognitive Functioning of Geriatric Patients: Is Hypovitaminosis D the Next Marker of Cognitive Dysfunction and Dementia?

“…Recently, it has been shown that serum vitamin D was lower in MCI and various stages of Alzheimer’s disease. Accordingly, vitamin D status could be treated as a useful biomarker for predicting and diagnosing MCI and Alzheimer disease [ 60 ]. This is in line with the results of a former study that indicated a positive association between MMSE test results and vitamin D concentration [ 61 ], although no correlation between MMSE and vitamin B12 levels has been observed.…”

Synergistic effect of Vitamin D Supplement and mindfulness on insulin resistance and different aspects of cognitive function in Vitamin D Deficient Type 2 Diabetic mellitus (T2DM) women: A pilot randomized clinical trial with placebo-controlled

“…For cognitive function, low levels of 25(OH)D is correlate with increased risk of cognitive impairments. furthermore, vitamin D has a vital role in healthy brain function and de ciency of vitamin D may lead to cognitive impairment (28) and vitamin D supplements improved cognitive function in various medical papulations (29,30). Also, mindfulness by affecting on dlpfc, amygdala, PFC and limbic system, has revealed improvements in cognitive functions (i.e., executive function, working memory and attention ) in younger and older patients (25).…”