Association between lower serum vitamin D (25-hydroxy-cholecalciferol) concentrations and cognitive impairment in older adults: data from a populational-based cohort study in a middle-income country

Objective: To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil. Design: Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013-2014. Setting: Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4 center dot 0-20 center dot 7 ng/ml; Q2: 20 center dot 8-26 center dot 6 ng/ml; Q3: 26 center dot 7-32 center dot 0 ng/ml and Q4: 32 center dot 1-60 center dot 1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group. Participants: 200 men and 371 women aged 60 years or older participated in this study. Results: The prevalence of probable cognitive impairment was 21 center dot 7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26 center dot 8 v. 24 center dot 6, P = 0 center dot 014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2 center dot 65, 95 % CI 1 center dot 46, 4 center dot 81), remaining significant in the adjusted analysis (OR 6 center dot 04, 95 % CI 2 center dot 78, 13 center dot 13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed. Conclusion: The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.