Serum Vitamin D Concentrations and Cognitive Change Over 20 Years: The Atherosclerosis Risk in Communities Neurocognitive Study

• Type of Material: Article
• Authors: Andrea L.C. Schneider, Johns Hopkins School of Medicine; Di Zhao, Johns Hopkins Bloomberg Sch Publ Hlth; Pamela L. Lutsey, University of Minnesota; Rebecca F. Gottesman, Johns Hopkins School of Medicine; A. Richey Sharrett, Johns Hopkins Bloomberg School of Public Health; Andreea M. Rawlings, Johns Hopkins Bloomberg School of Public Health; Alvaro Alonso, Emory University; David Knopman, Mayo Clinic; Thomas H. Mosley, University of Mississippi; Elizabeth Selvin, Johns Hopkins Bloomberg School of Public Health; Erin D. Michos, Johns Hopkins Bloomberg School of Public Health
• Language: English
• Date: 2018-01-01
• Publisher: Karger Publishers
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 S. Karger AG, Basel. Copyright: All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1159/000490912
• Title of Journal or Parent Work: Neuroepidemiology
• ISSN: 0251-5350
• Volume: 51
• Issue: 3-4
• Start Page: 131
• End Page: 137
• Grant/Funding Information: The ARIC Study is collaboratively funded by NIH/NHLBI contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HH-SN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C.; Dr. Andrea L.C. Schneider is supported by the NIH/NINDS via an administrative supplement to award R25NS065729.; Additionally, Drs. Di Zhao and Erin D. Michos are supported by the Blumenthal Scholars Fund at Johns Hopkins for preventive cardiology research.; This work was supported by grant R01NS072243 from NIH/ NINDS to Dr. Erin D. Michos, by grant R01HL103706 from NIH/ NHLBI to Dr. Pamela L. Lutsey, and by grant R01HL103706-S1 from the National Institutes of Health Office of Dietary Supplements to Dr. Pamela L. Lutsey.; ARIC-NCS was funded by U01 HL096812, HL096814, HL096899, HL096902, and HL096917, with additional NIH/NINDS support.
• Keywords: ASSOCIATION; Neurosciences & Neurology; Public, Environmental & Occupational Health; Science & Technology; Life Sciences & Biomedicine; Cognition; DEMENTIA; Vitamin D; COHORT; Clinical Neurology; 25-HYDROXYVITAMIN D; DECLINE; D DEFICIENCY; Cohort study; DIET; WOMEN
• Research Categories: Health Sciences, Public Health; Biology, Neuroscience; Health Sciences, Epidemiology

Abstract

Background/Aims: 25-hydroxyvitamin D (25[OH]D) concentrations have been associated with cognitive decline and incident dementia in elderly populations; however, these relationships are susceptible to reverse causation. Less is known about the association of midlife 25(OH)D with long-term cognitive decline. Methods: This was a prospective cohort study of 13,044 participants (mean age 57 years at baseline) in the Atherosclerosis Risk in Communities Study. 25(OH)D was measured from serum collected at baseline (1990-1992) using liquid chromatography tandem high-sensitivity mass spectrometry. Cognition was assessed using 3 neuropsychological tests at 3 time points, which were combined into a composite cognitive Z-score. Multivariable-adjusted linear mixed-effects models with random intercepts and slopes were used to estimate associations between 25(OH)D and cognitive change over 20 years. Results: Compared to persons with sufficient 25(OH)D (≥30 ng/mL), those with deficient (< 20 ng/mL) and intermediate (20-< 30 ng/mL) 25(OH)D concentrations had similar cognitive decline in composite cognitive Z-scores (deficient versus sufficient: -0.035 [95% CI -0.104 to 0.033] and intermediate versus sufficient: -0.029 [95% CI -0.080 to 0.023]). Conclusions: Lower concentrations of 25(OH)D measured in midlife were not significantly associated with more rapid cognitive decline over a 20-year follow-up period. The results of this prospective study are less susceptible to reverse causation than prior studies.