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

Yoichi Matsunaga,Midori Suenaga,Funda F. Bölükbaşı Hatip,Yoshio Tsuboi,Izzettin Hatip‐Al‐Khatib,Shinji Ouma

doi:10.1002/brb3.936

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.

Highlights

Alzheimer’s disease (AD) is the most common cause of cognition impairment in elderly populations
A definitive diagnosis of AD can only be made based on histopathological examination of brain specimens, the clinical diagnosis of AD could have a high degree of accuracy if dementia is diagnosed using a cognitive score (Creavin et al, 2016; Votruba, Persad, & Giordani, 2016)
It has been reported that 10%–20% of individuals over the age of 65 years suffer from Mild cognitive impairment (MCI) (Petersen, 2011), with high potential of converting to AD (Devanand et al.,2008; Ganguli et al, 2011; Petersen et al, 2001; Ritchie & Touchon, 2000)

Summary

Introduction

Alzheimer’s disease (AD) is the most common cause of cognition impairment in elderly populations. A definitive diagnosis of AD can only be made based on histopathological examination of brain specimens, the clinical diagnosis of AD could have a high degree of accuracy if dementia is diagnosed using a cognitive score (Creavin et al, 2016; Votruba, Persad, & Giordani, 2016). In addition to age and gender, the Mini-Mental State Examination (MMSE) has been regarded as a useful instrument for evaluating the cognitive state of patients (Folstein, Folstein, & McHugh, 1975) and used as a predictor of AD (Musicco et al, 2009). Mild cognitive impairment (MCI) is subclinical complaint of memory function in elderly people. It has been reported that 10%–20% of individuals over the age of 65 years suffer from MCI (Petersen, 2011), with high potential of converting to AD (Devanand et al.,2008; Ganguli et al, 2011; Petersen et al, 2001; Ritchie & Touchon, 2000)

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