title: Individuals with exceptional longevity manifest a delayed association between vitamin D insufficiency and cognitive impairment.
abstract: OBJECTIVE
  To define vitamin D levels and their association with cognition in subjects with exceptional longevity.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Community and long-term care facilities.
  
  
  METHODS
  Ashkenazi Jewish subjects (n = 253) with exceptional longevity, with comparison made to the Third National Health and Nutrition Examination Survey (NHANES III) participants aged 70 and older.
  
  
  METHODS
  Serum 25-hydroxyvitamin D levels were measured using liquid chromatography/tandem mass spectrometry analysis. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and clock drawing test (CDT: command and copy).
  
  
  RESULTS
  The median age of the Ashkenazi subjects was 97 (interquartile range (IQR) 95-104). Age-associated rise in the prevalence of vitamin D insufficiency, defined as a serum vitamin D level of less than 30 ng/mL, was noted in NHANES III (P = .001). In the Ashkenazi group with longevity, the rate of vitamin D insufficiency was comparable with that of the NHANES III participants, who were up to 25 years younger. In the cohort with exceptional longevity, 49% demonstrated cognitive impairment as assessed according to MMSE score (impaired cognition, median 9.5 IQR 0-24); normal cognition, median 29 (IQR 18-30) P < .001). Vitamin D insufficiency was more prevalent in those with impaired cognition, defined according to the MMSE (71.8% vs 57.7%, P = .02) and the CDT copy (84.6% vs. 50.6%, P = .02), than in those with normal cognition. This association remained significant after multivariable adjustment in logistic regression models for cognitive assessments made using the MMSE (odds ratio (OR) = 3.2, 95% confidence interval (CI) = 1.1-9.29, P = .03) and the CDT copy (OR = 8.96, 95% CI = 1.08-74.69, P = .04).
  
  
  CONCLUSIONS
  Higher vitamin D levels may be a marker of delayed aging, because they are associated with better cognitive function in people achieving exceptional longevity.
authors.affiliation: Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York; Institute for Aging Research, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Sofiya
authors.initials: S
authors.lastname: Milman
authors.forename: Micol
authors.initials: M
authors.lastname: Schulder-Katz
authors.forename: Jennifer
authors.initials: J
authors.lastname: Deluty
authors.forename: Molly E
authors.initials: ME
authors.lastname: Zimmerman
authors.forename: Jill P
authors.initials: JP
authors.lastname: Crandall
authors.forename: Nir
authors.initials: N
authors.lastname: Barzilai
authors.forename: Michal L
authors.initials: ML
authors.lastname: Melamed
authors.forename: Gil
authors.initials: G
authors.lastname: Atzmon
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002853:Chromatography, Liquid; D003072:Cognition Disorders / Q000453:epidemiology* / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007585:Jews / Q000208:ethnology; D008136:Longevity; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D053719:Tandem Mass Spectrometry; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000208:ethnology
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: cognitive function; exceptional longevity; vitamin D