title: [Relationship between 25-hydroxy vitamin D and cognitive status in older adults: the COGNIDAGE study].
abstract: OBJECTIVE
  The aim of the COGNIDAGE study was to examine the association between 25(OH)D and cognitive status in a group of elderly patients with vitamin D deficiency and high burden of comorbidities attending Geriatric Outpatient Clinics.
  
  
  METHODS
  We studied the relationship between 25(OH)D and cognitive functions taking into account comorbidities and cognitive functions assessed by MMSE (Mini Mental State Examination), CDT (Clock Drawing Test) and CIRS (Cumulative Illness Rating Scale), in 132 consecutive elderly patients with low levels of 25(OH)D (<10 ng/ml) compatible with the condition of vitamin deficiency. The association among 25(OH)D levels, MMSE score, CDT score and CIRS scores were analyzed using Pearson correlation. All the elderly patients received an adequate vitamin D supplementation and were reassessed after 6 months.
  
  
  RESULTS
  At baseline, mean MMSE and CIRS scores were: 21.8+5.56 and 2.96 +1.63 respectively. Mean CDT score was 3,66+-2.05. No associations were found between 25(OH)D levels and global cognitive function. A significant relationship was observed between the total CIRS score and 25(OH)D levels (r=0.305; p=0.000) as well as between total CIRS score and MMSE (r=-0.375; p=0.000). After 6 months, 83.9 % had 25(OH)D levels >20 ng/ml. Mean MMSE and CDT scores were 22.20+-5.76 and 3.90+-2.06 respectively. There was no significant correlation among 25(OH)D, MMSE and CDT scores while a significant correlation was found between 25(OH)D and CIRS- severity score (r=0.275; p=0.001) and between MMSE and total CIRS scores (r=-0.247; p=0.005 for CIRS-comorbidities; r=-0.184; p=0.04 for CIRS-severity). A post hoc evaluation on two subgroups of elderly patients (the first with vitamin D deficiency without cognitive impairment, the second with vitamin D deficiency and dementia) showed a statistically significant difference (p=0.00001) regarding the CIRS-comorbidities scores.
  
  
  CONCLUSIONS
  In our cohort of elderly patients with a high burden of comorbidities, 25(OH)D low levels (<10 ng/ml) are not associated with MMSE and CDT scores. There is no statistically difference among the levels of 25(OH)D and MMSE and CDT scores after 6 months. The strong correlation we found regarding CIRS-comorbidities in the two sub-groups suggests that vitamin D deficiency may play a role in promoting cognitive impairment only with comorbidities.
authors.affiliation: Centro delle Demenze, Distretto Sanitario 51, ASL NA 3 Sud, Pomigliano d'Arco (NA) - Coordinatore dello studio COGNIDAGE.
authors.forename: Ciro
authors.initials: C
authors.lastname: Manzo
authors.affiliation: Casa della Salute di Chiaravalle, Azienda Sanitaria Provinciale, Catanzaro - Co-coordinatori dello studio COGNIDAGE.
authors.forename: Alberto
authors.initials: A
authors.lastname: Castagna
authors.affiliation: Ospedale Galliera, Genova - Co-coordinatori dello studio COGNIDAGE.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Palummeri
authors.affiliation: Scuola del Farmaco e dei Prodotti della Salute, Università di Camerino (MC).
authors.forename: Enea
authors.initials: E
authors.lastname: Traini
authors.affiliation: Geriatria Ospedaliera e Territoriale ASL To2, Torino.
authors.forename: Antonino Maria
authors.initials: AM
authors.lastname: Cotroneo
authors.affiliation: Programma Demenze, Direzione Sanitaria AUSL Modena.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fabbo
authors.affiliation: Ambulatorio di Medicina Interna, Plesso Ospedaliero Gragnano, Distretto Sanitario 58, ASL NA 3 Sud, Gragnano (NA).
authors.forename: Maria
authors.initials: M
authors.lastname: Natale
authors.affiliation: Ambulatorio Disturbi Cognitivi, Azienda Sanitaria Provinciale, Catanzaro.
authors.forename: Pietro
authors.initials: P
authors.lastname: Gareri
authors.affiliation: UO Assistenza Anziani, Distretto 30, ASL NA 1, Napoli.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Putignano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology*; D015897:Comorbidity; D003704:Dementia / Q000188:drug therapy / Q000209:etiology; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D