Abstract
Background: As life expectancy increases, cognitive performance decline in the elderly has become one of the major global challenges. We aimed to evaluate the association of dietary vitamin D (VD), serum 25-hydroxyvitamin D3 (25(OH)D3), 25-hydroxyvitamin D2 (25(OH)D2), and total 25-hydroxyvitamin (25(OH)D) concentration with cognitive performance in older Americans. Methods: The data from the National Health and Nutrition Examination Survey (NHANES), 2011–2014 was used. The cognitive performance was assessed by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning sub-test, Animal Fluency test, and Digit Symbol Substitution Test (DSST). A binary logistic regression model was applied to evaluate the association between VD and cognitive performance, and restricted cubic spline model was adopted to evaluate the dose–response relationship. Results: While comparing to the lowest dietary VD intake group, the multivariate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of the highest dietary VD intake group were 0.51 (0.36–0.72) for the Animal Fluency test score and 0.45 (0.31–0.66) for DSST score, respectively; and those of serum total 25(OH)D and 25(OH)D3 concentration were 0.68 (0.47–0.97) and 0.62 (0.44–0.86) for DSST score. L-shaped relationships were identified for dietary VD intake, serum total 25(OH)D and 25(OH)D3 concentration with cognition performance. The associations between dietary VD intake, serum total 25(OH)D and cognitive performance were non-significant when stratified by gender. Conclusions: The study indicates that dietary VD intake, serum total 25(OH)D and 25(OH)D3 concentration were positively associated with cognitive performance. Further studies are needed to clarify the possible effects of dietary VD intake and serum 25(OH)D2, 25(OH)D3 on cognitive performance.
Highlights
As life expectancy increases, cognitive performance decline in the elderly has become one of the major global challenges [1]
We aimed to investigate the association and dose–response relationships of dietary Vitamin D (VD) intake, serum total 25(OH)D, serum 25(OH)D2, and serum 25(OH)D3 with cognitive performance in older Americans based on the data from the National Health and Nutrition Examination Survey (NHANES)
We could see that people who were non-Hispanic white, with lower educational level, lower income, higher prevalence of diabetes, hypertension, and stroke, often alcohol drinkers, with lower physical activity level, and higher total energy intake had lower cognitive performance
Summary
Cognitive performance decline in the elderly has become one of the major global challenges [1]. Considering the social and economic burden of cognitive decline especially dementia, it is important to control, delay, and prevent cognitive decline. The history of illness, and life stress may increase the risk of cognitive performance decline. Healthy dietary habits, such as proper intake of vitamin C, vitamin E, and polyunsaturated fatty acids, may have a protective effect on cognitive performance [3,4,5]. VD is neuroprotective, anti-inflammatory, and antioxidant, so it is considered to be one of the protective factors for cognitive performance [7].
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