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Nutrition, Vitamins & Supplements for Seniors

Low Vitamin D in Senior Citizens Signals Cognitive Decline; Higher Parkinson’s Risk

An estimated 40 to 100% of seniors in U.S. and Europe are deficient in vitamin D: linked to fractures, various chronic diseases and death

July 12, 2010 - Senior citizens with low levels of vitamin D are likely to experience declines in thinking, learning and memory over a six-year period, according to a study in the July 12 issue of Archives of Internal Medicine. Low levels of the vitamin may also increase the risk for Parkinson's disease, according to a finding that people with higher levels of vitamin D appear to have a reduced risk of developing Parkinson's disease. This study is in another of the JAMA/Archives journals, Archives of Neurology.

Low Vitamin D Levels Associated With Cognitive Decline

An estimated 40 to 100 percent of older adults in the United States and Europe are deficient in vitamin D, according to the article. This deficiency has been linked to fractures, various chronic diseases and death.

Vitamin D may help prevent the degeneration of brain tissue by having a role in formation of nervous tissue, maintaining levels of calcium in the body, or clearing of beta-amyloid, the substance that forms the brain plaques and tangles associated with Alzheimer's disease.

 

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David J. Llewellyn, Ph.D., of University of Exeter, England, and colleagues assessed blood levels of vitamin D in 858 adults who were age 65 or older when the study began in 1998.

Participants completed interviews and medical examinations and provided blood samples. At the beginning of the study and again after three and six years, they repeated three tests of cognitive function—one assessing overall cognition, one focusing on attention and one that places greater emphasis on executive function, or the ability to plan, organize and prioritize.

Participants who were severely deficient in vitamin D (having blood levels of 25-hydroxyvitamin D of less than 25 nanomoles per liter) were 60 percent more likely to have substantial cognitive decline in general over the six-year period and 31 percent more likely to experience declines on the test measuring executive function than those with sufficient vitamin D levels.

"The association remained significant after adjustment for a wide range of potential confounders and when analyses were restricted to elderly subjects who were non-demented at baseline," the authors write. However, no significant association was seen for the test measuring attention.

"If future prospective studies and randomized controlled trials confirm that vitamin D deficiency is causally related to cognitive decline, then this would open up important new possibilities for treatment and prevention," the authors concluded

The study received funding from the Health Research Council of New Zealand

Editorial says trials needed to check growing claims for Vitamin D

Vitamins and Minerals: About Vitamin D

Vitamins are organic substances (made by plants or animals), minerals are inorganic elements that come from the earth; soil and water and are absorbed by plants. Animals and humans absorb minerals from the plants they eat. Vitamins and minerals are nutrients that your body needs to grow and develop normally.

Vitamins and minerals have a unique role to play in maintaining your health. For example Vitamin D helps your body absorb the amount of calcium (a mineral) it needs to form strong bones. A deficiency in vitamin D can result in a disease called rickets (softening of the bones caused by the bodies inability to absorb the mineral calcium.) The body cannot produce calcium; therefore, it must be absorbed through our food.

Other minerals like chromium, copper, iodine, iron, selenium, and zinc are called trace minerals because you only need very small amounts of them each day. The best way to get enough vitamins is to eat a balanced diet with a variety of foods. You can usually get all your vitamins from the foods you eat.

About Vitamin D

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Vitamin D obtained from sun exposure, food, and supplements is biologically inert and must undergo two hydroxylations in the body for activation.

The first occurs in the liver and converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D [1,25(OH)2D], also known as calcitriol.

Vitamin D is essential for promoting calcium absorption in the gut and maintaining adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and prevent hypocalcemic tetany.

It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults.

Together with calcium, vitamin D also helps protect older adults from osteoporosis.

Vitamin D has other roles in human health, including modulation of neuromuscular and immune function and reduction of inflammation. Many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D. Many laboratory-cultured human cells have vitamin D receptors and some convert 25(OH)D to 1,25(OH)2D. It remains to be determined whether cells with vitamin D receptors in the intact human carry out this conversion.

>> Read more at the National Institutes of Health, Office Dietary Supplements

"Vitamin D has been known for many years to play a critical role in skeletal health, such that very low levels of this hormone (less than 20 nanomoles per liter) can cause osteomalacia, a disorder of impaired bone mineralization," write Andrew Grey, M.D., and Mark Bolland, M.B.Ch.B., Ph.D., of University of Auckland, New Zealand, in an accompanying editorial.

"More recently, observational studies have reported inverse associations between levels of serum 25-hydroxyvitamin D, the metabolite that best reflects overall vitamin D status, and the risk of a wide range of disease, including cancer, vascular disease, infectious conditions, autoimmune diseases, osteoporosis, type 2 diabetes mellitus and obesity."

"The results of these observational studies have prompted calls for widespread treatment of individuals with low levels of vitamin D and the establishment of public health programs aimed at raising the population levels of vitamin D to 'healthy' values," the editorial states.

"It is now time to test the various hypotheses generated by observational studies of vitamin D, including that of Llewellyn et al, in adequately designed and conducted randomized controlled trials.

"Very importantly, such trials will also provide an opportunity to systematically assess potential harms of vitamin D supplementation, an issue that has been largely overlooked or dismissed. We should invest in trials that provide the best possible evidence on the benefits and risks of vitamin D before we invest in costly, difficult and potentially unrewarding interventional strategies."

Vitamin D Levels Associated With Parkinson's Disease Risk

The study on Vitamin D and Parkinson’s disease found that older people in the highest quartile (one-fourth of the study population) of serum vitamin D levels had a 67 percent lower risk of developing Parkinson's disease than those in the lowest quartile of vitamin D levels.

Vitamin D is known to play a role in bone health and may also be linked to cancer, heart disease and type 2 diabetes, according to background information in the article in the July issue of Archives of Neurology.

"Recently, chronically inadequate vitamin D intake was proposed to play a significant role in the pathogenesis of Parkinson's disease," the authors write.

"According to the suggested biological mechanism, Parkinson's disease may be caused by a continuously inadequate vitamin D status leading to a chronic loss of dopaminergic neurons in the brain."

Paul Knekt, D.P.H., and colleagues at the National Institute for Health and Welfare, Helsinki, Finland, studied 3,173 Finnish men and women age 50 to 79 who did not have Parkinson's disease at the beginning of the study, in 1978 to 1980.

Participants completed questionnaires and interviews about socioeconomic and health background, underwent baseline examinations and provided blood samples for vitamin D analysis.

Over a 29-year follow-up, through 2007, 50 of the participants developed Parkinson's disease. After adjusting for potentially related factors, including physical activity and body mass index, individuals in the highest quartile (one-fourth of the study population) of serum vitamin D levels had a 67 percent lower risk of developing Parkinson's disease than those in the lowest quartile of vitamin D levels.

"Despite the overall low vitamin D levels in the study population, a dose-response relationship was found," the authors write.

"This study was carried out in Finland, an area with restricted sunlight exposure, and is thus based on a population with a continuously low vitamin D status. Accordingly, the mean [average] serum vitamin D level in the present population was about 50 percent of the suggested optimal level (75 to 80 nanomoles per liter). Our findings are thus consistent with the hypothesis that chronic inadequacy of vitamin D is a risk factor for Parkinson's disease."

The exact mechanisms by which vitamin D levels may affect Parkinson's disease risk are unknown, but the nutrient has been shown to exert a protective effect on the brain through antioxidant activities, regulation of calcium levels, detoxification, modulation of the immune system and enhanced conduction of electricity through neurons, the authors note.

"In intervention trials focusing on effects of vitamin D supplements, the incidence of Parkinson disease merits follow up," they conclude

This work was supported by a National Institutes of Health grant.

An editorial in same issue says study add to study of neurological effects of vitamin D

The study is the first “longitudinal analysis of vitamin D status as a risk of incident Parkinson's disease,” writes Marian Leslie Evatt, M.D., M.S., of Emory University, Atlanta, in an accompanying editorial.

"A growing body of basic research lends plausibility to a role for adequate vitamin D status protecting against development of Parkinson's disease," Dr. Evatt writes.

"Knekt and colleagues' study provides the first promising human data to suggest that inadequate vitamin D status is associated with the risk of developing Parkinson's disease, but further work is needed in both basic and clinical arenas to elucidate the exact role, mechanisms and optimum concentration of vitamin D in Parkinson's disease."

 

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