The effect of vitamin D on cognitive functions in young female patients: a prospective controlled study using the Montreal Cognitive Assessment

Balbaloglu, Ozlem; Tanık, Nermin

doi:10.1590/0004-282X20180159

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Article • Arq. Neuro-Psiquiatr. 77 (1) • Jan 2019 • https://doi.org/10.1590/0004-282X20180159 copy

The effect of vitamin D on cognitive functions in young female patients: a prospective controlled study using the Montreal Cognitive Assessment

O efeito da vitamina D nas funções cognitivas em pacientes jovens do sexo feminino: um estudo prospectivo controlado usando a avaliação cognitiva de Montreal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Aim:

Our aim was to determine whether there is a relationship between vitamin D [25(OH)D] and cognitive functioning in women with low 25(OH)D levels.

Methods:

Ninety female patients, 25-45 years of age, who attended our outpatient clinic and had 25(OH)D levels < 30 ng/mL, were included. The Montreal Cognitive Assessment (MoCA) scale was used to determine cognitive functioning; the scale is divided into seven subgroups. Patients were divided into three subgroups according to their 25(OH)D levels. After a three-month period of 25(OH) D replacement, the patients underwent a re-evaluation using the MoCA scale.

Results:

The total MoCA score before treatment was significantly different from the score after treatment (p < 0.05). Language and delayed recall functions were significantly different before and after treatment (p < 0.05).

Conclusion:

Vitamin D levels were related to cognitive functioning in our study group.

Keywords:
Vitamin D; cognition; Montreal cognitive assessment

Variable		Group 1 (vitamin D < 10 ng/mL)	Group 2 (vitamin D = 10 - < 20 ng/mL)	Group 3 (vitamin D = 20 - < 29 ng/mL)	Total	p-value
Variable		n = 30	n = 30	n = 30	n = 90	p-value
Age		37.07 ± 4.5	38.13 ± 5.9	36.83 ± 5.4	3726 ± 5.3	0.73^F
Education n (%)
	Middle school	17 (43.6)	11 (28.2)	11 (28.2)	39(100)
	High school	9 (27.3)	12 (36.4)	12 (36.4)	33(100)	0.49^CST
	University	4 (22.2)	7 (38.9)	7 (38.9)	18(100)
25(OH)D (ng/mL)		5.95 ± 1.9	15.16 ± 2.7	22.70 ± 1.9		0.02^* * Statistical significance: p < 0.05; ALP: Alkaline phosphatase; PTH: Parathyroid hormone; Normal ranges: calcium; 8.8-10.6 mg/dL, phosphorus; 2.5-4.5 mg/dL, ALP: 30-120 U/L, PTH; 12-88 pg/mL, 25(OH)D > 30 ng/mL.
PTH (pg/mL)		90.43 ± 11.8	72.29 ± 20.3	71.94 ± 18.9		0.45
Ca (mg/dL)		9.37 ± 0.4	9.53 ± 0.4	9.20 ± 1.8		0.49
Phosphorus (mg/dL)		2.21 ± 0.5	2.12 ± 0.4	2.25 ± 0.4		0.79
ALP (U/L)		63.90 ± 15.4	68.07 ± 15.5	65.30 ± 19		0.50

Vitamin D	Group 1	Group 2	Group 3	Total
Vitamin D	X ± SD	X ± SD	X ± SD	X ± SD
Before treatment	5.95 ± 1.95	15.16 ± 2.76	22.98 ± 1.91	14.69 ± 7.34
After treatment	45.07 ± 8.37	50.22 ± 6.55	52.42 ± 5.50	49.24 ± 7.50
Test^* * Paired T test; statistical significance p < 0.05.	p < 0.001	p < 0.001	p < 0.001	p < 0.001

MoCA Subgroups		Group 1	Group 2	Group 3	Total MoCA
MoCA Subgroups		X ± SD	X ± SD	X ± SD	X ± SD
Visual Structuring
	Before treatment	3.33 ± 0.75	3.60 ± 0.67	3.83 ± 0.37	3.59 ± 0.65
	After treatment	3.83 ± 0.37	4.0 ± 0.00	3.8 ± 0.37	3.93 ± 0.25
	Test^* * Paired T test,	p = 0.001	p = 0.003	p = 1.000	p < 0.001
Language
	Before treatment	4.10 ± 0.54	4.30 ± 0.53	4.57 ± 0.50	4.32 ± 0.55
	After treatment	4.33 ± 0.54	4.50 ± 0.50	4.73 ± 0.45	4.52 ± 0.52
	Test^* * Paired T test,	p = 0.01	p = 0.01	p = 0.02	p < 0.001
Executive Functions
	Before treatment	1.53 ± 0.62	1.53 ± 0.50	1.27 ± 0.64	1.44 ± 0.60
	After treatment	1.73 ± 0.45	1.80 ± 0.40	1.70 ± 0.46	1.74 ± 0.43
	Test^* * Paired T test,	p = 0.08	p = 0.009	p = 0.002	p < 0.001
Time/Place Orientation
	Before treatment	6.0 ± 0.0	6.0 ± 0.0	5.97 ± 0.18	5.99 ± 0.10
	After treatment	6.0 ± 0.0	6.0 ± 0.0	6.0 ± 0.0	6.0 ± 0.0
Test^* * Paired T test,		^¥ ¥ Because the standard deviation being zero, was not analyzed; statistical significance p < 0.05; MoCA = Montreal Cognitive Assessment.	^¥ ¥ Because the standard deviation being zero, was not analyzed; statistical significance p < 0.05; MoCA = Montreal Cognitive Assessment.	p = 0.32	p = 0.32
Conceptual Thinking
	Before treatment	1.13 ± 0.62	1.07 ± 0.58	1.20 ± 0.66	1.13 ± 0.62
	After treatment	1.20 ± 0.55	1.20 ± 0.61	1.40 ± 0.62	1.27 ± 0.59
	Test^* * Paired T test,	p = 0.42	p = 0.25	p = 0.05	p = 0.02
Delayed Recall
	Before treatment	3.30 ± 0.98	3.80 ± 0.88	4.10 ± 0.88	3.73 ± 0.96
	After treatment	4.53 ± 0.73	4.50 ± 0.73	4.57 ± 0.56	4.53 ± 0.67
	Test^* * Paired T test,	p < 0.001	p < 0.001	p = 0.001	p < 0.001
Attention, Concentration, Memory
	Before treatment	3.33 ± 1.18	3.63 ± 1.42	3.63 ± 1.27	3.53 ± 1.29
	After treatment	3.60 ± 1.22	3.93 ± 1.33	3.83 ± 1.23	3.79 ± 1.25
	Test^* * Paired T test,	p = 0.05	p = 0.02	p = 0.11	p = 0.001
Total MoCA
	Before treatment	22.50 ± 1.13	23.90 ± 1.56	24.40 ± 1.83	23.60 ± 1.72
	After treatment	25.10 ± 1.47	25.53 ± 1.52	26.00 ± 1.62	25.56 ± 1.55
	Test^* * Paired T test,	p < 0.001	p < 0.001	p < 0.001	p < 0.001

MoCA total score		MoCA before treatment			MoCA after treatment
MoCA total score		Group1	Group 2	Group 3	Group1	Group 2	Group 3
Before treatment
	Group 1	–	0.002^* * Statistical significance p < 0.05.	< 0.001^* * Statistical significance p < 0.05.
	Group 2	0.002^* * Statistical significance p < 0.05.	–	0.42
After treatment
	Group 1				–	0.51	0.05
	Group 2				0.51	–	0.41

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[1] Correspondence: Ozlem Balbaloglu; Bozok University Department of Physical Treatment and Rehabilitation Yozgat, Turkey; E-mail: ozlembalbaloglu@yahoo.com