Low Vitamin D Linked to Alzheimer's

Disease
September 28, 2012 Yet another study has linked low vitamin D levels with signifiant health
issues in this ase, poor ognition!
"n this latest systemati review, people with #l$heimer%s disease &#D' had lower onentrations
of vitamin D than those without #D, and better ognitive test results were assoiated to higher
vitamin D onentrations! (he review enompassed )* studies, inluding 21 ross+setional, 10
ase+ontrol, 1 before+after with a omparison group, and 2 prospetive ohort studies, as well as
) randomi$ed, ontrolled trials &,-(s'! (he study sample si$es varied from 2* to 1*,0..
partiipants!
/ow e0atly vitamin D protets the brain is not lear, but researh suggests that vitamin D ats
as a neurosteroid! #t the moleular level, the brain &the hypothalamus and large neurons in the
substantia nigra' an synthesi$e the ative form of vitamin D 11,22&3/'D4! 5any genes are
regulated by vitamin D, whih ontributes to neuroprotetion by modulating the prodution of
suh things as nerve growth fator, and regulating neurotransmitters!
(he ideal onentration of vitamin D is also not really known, however there are 2 ut points
reommended worldwide6 20 and *2 nmol78! ,eommendation supplements 900 ": of vitamin
D daily for older hildren and adults; reommendations differ for younger hildren and pregnant
women!
Vitamin D Testing
3ntario%s universal healthare system does not provide for vitamin D testing e0ept for ertain
onditions &osteoporosis, osteopenia, rikets, malabsorption syndrome, renal disease, or taking
mediations that affet vitamin D metabolism' beause the evidene is not yet established!
#merians are beoming more aware of vitamin D%s health benefits and are taking more
supplements; however, although the vitamin is fat soluble, and so may be safer than some other
vitamins when taken at higher doses
Large Review Casts Cloud Over Vitamin-D Health Beneits
8ow onentrations of 22+hydro0yvitamin D &2213/4D' are most likely an effet of health
disorders and not a ause of illness, onludes a omprehensive review of observational studies
and randomi$ed linial trials of vitamin+D status and health! (he new analysis, whih inluded
2.0 prospetive ohort studies of adults aged 18 years or older, showed moderate to strong
assoiations between lower onentrations of 22&3/'D and higher risk for onditions ranging
from ardiovasular disease to infetious disease, gluose+metabolism disorders, and mood
disorders! "n addition, researhers found no effet on disease ourrene as a result of
supplementation, by evaluating 1*2 randomi$ed linial trials, inluding )< intervention studies
involving vitamin+D supplementation of patients with low 22&3/'D onentrations! =(he
disrepany between observational and interventional studies suggests that low 22&3/'D is a
marker of ill health,=!
>ey mehanism that auses lower 22&3/'D onentrations in people with illness is disease+
related inflammation! ="nflammatory proesses involved in disease ourrene and linial
ourse would redue 22&3/'D, whih would e0plain why low vitamin+D status is reported in a
wide range of disorders!
!o "e#t o Vitamin-D $u%%lementation in Dia&etes' Can#er
3bservational studies showed an assoiation between type 2 diabetes and low vitamin+D levels,
supplementation with the vitamin had no effet on reduing /b#1!
(he data also showed that high 22&3/'D onentrations were assoiated with a protetive effet
on oloretal aner, but not other aners! /owever, 2 large intervention trials showed no
redued risk of any aners, inluding oloretal, with vitamin+D supplementation!
vitamin+D supplementation of 20 ?g7day in the elderly population &mainly women' show a slight
redution in all+ause mortality if they reeived! /owever, the authors speulate that the
improvement ould be related to vitamin+D defiits aused not diretly by the illness itself but by
lifestyle hanges resulting from the illness, suh as a lak of mobility, restritions on e0posure to
sunlight, or dietary modifiations related to treatment! ="n elderly people, restoration of vitamin+
D defiits due to aging and lifestyle hanges indued by ill health ould e0plain why low+dose
supplementation leads to slight gains in survival,=
(urther )nsights *ill "merge (rom Ongoing Trials
(he researhers note that important further insights should emerge from 2 trials that are urrently
under way! (hese trials involve between 2120 and 20,000 patients aged 20 years or older and are
investigating the effets of <0 to 80 ?g7day of vitamin+D supplementation on the risk of aner,
ardiovasular disease, diabetes, infetions, delining ognitive funtion, and fratures!
=(he first results are not e0peted before 201*, but these studies have the potential to test our
hypotheses,= they observe!
Vitamin-D $u%%lementation +)ll-Advised+
Some supplementation if an individual%s vitamin+D onentration falls below a =suffiieny=
threshold of *2 nmol78 ontinues to be reommended! (he wealth of evidene from randomi$ed
trials shows that this medial behavior is not grounded and taking vitamin+D supplements will
make no differene on health status and it would be wiser to seek reasons underlying the low
vitamin+D level, suh as inflammatory proesses or undiagnosed ardiovasular diseases, and fi0
them!=
!o Link Between Vitamin D and Cognition'
Brain ,atholog-
@nthusiasm for taking vitamin D to promote brain health has taken a knok after 2 studies in the
same population have found no assoiation between vitamin D levels and ognition or
erebrovasular pathology! (he ognition study did not find signifiant assoiations between
lower levels of 22&3/'D and lower ognitive test sores at baseline, hange in sores over time,
or dementia risk in 1920 individuals! (he 5," study inluded 1922 individuals from the same
population who underwent baseline brain 5,", 888 of whom had a seond brain 5,"
e0amination 10 years later! ,esults showed that 22&3/'D levels were not assoiated with white
matter hyperintensities or prevalent sublinial infarts in ross+setional or prospetive
analyses!
Cause o Disease or .ust a /arker0
8ow levels of vitamin D are believed by many to be a potential risk fator for ardiovasular and
brain disease! Arevious studies have shown assoiations between low levels of vitamin D and
hypertension, diabetes, myoardial infartion, and stroke! #lthough low vitamin D has been
assoiated with poor outomes, it may Bust be a marker of poor health! Aeople in poor health are
likely to spend less time outside so will onseCuently have lower levels of vitamin D!
Deause low vitamin D has been assoiated hypertension and diabetes, whih in turn have been
assoiated with white matter hyperintensities and ognitive impairment, their hypothesis was that
low levels of vitamin D would be assoiated with white matter hyperintensities, silent strokes,
and ognitive impairment! (here isnEt any relationship between vitamin D levels and any of these
outomes in analyses!
(here have been several studies on low vitamin D and ognition, many of whih have shown a
positive assoiation! (here was one other ross+setional study that looked at vitamin D and
brain pathology at one time point and that was positive!
Some suh studies are now underway! 3ne is the Fational "nstitutes of /ealthGsponsored H"(#8
study looking at the inidene of stroke and myoardial infartion in older individuals randomly
assigned to 2000 ": of vitamin D or plaebo!