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Calcium and vitamin D supplementation and cognitive impairment in the women's health initiative.

ABSTRACT: Objectives: To examine the effects of vitamin D and calcium on cognitive outcomes in elderly women.

Design: Post hoc analysis of a randomized double-blind placebo-controlled trial.

Setting: Forty Women's Health Initiative (WHI) clinical centers across the United States.

Participants: Four thousand one hundred forty-three women aged 65 and older without probable dementia at baseline who participated in the WHI Calcium and Vitamin D Trial and the WHI Memory Study.

Intervention: Two thousand thirty-four women were randomized to receive 1,000 mg of calcium carbonate combined with 400 IU of vitamin D(3) (treatment) and 2,109 to placebo.

Measurements: Primary: classifications of probable dementia or mild cognitive impairment (MCI) based on a four-phase protocol that included central adjudication. Secondary: global cognitive function and individual cognitive subtests.

Results: Mean age of participants was 71. During a mean follow-up of 7.8 years, 39 participants in the treatment group and 37 in the placebo group developed incident dementia (hazard ratio (HR) = 1.11, 95% confidence interval (CI) = 0.71-1.74, P = .64). Likewise, 98 treatment participants and 108 placebo participants developed incident MCI (HR = 0.95, 95% CI = 0.72-1.25, P = .72). There were no significant differences in incident dementia or MCI or in global or domain-specific cognitive function between groups.

Conclusion: There was no association between treatment assignment and incident cognitive impairment. Further studies are needed to investigate the effects of vitamin D and calcium separately, on men, in other age and ethnic groups, and with other doses.

SUBMITTER: Rossom RC

PROVIDER: S-EPMC3521077 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Calcium and vitamin D supplementation and cognitive impairment in the women's health initiative.

Rossom Rebecca C RC Espeland Mark A MA Manson Joann E JE Dysken Maurice W MW Johnson Karen C KC Lane Dorothy S DS LeBlanc Erin S ES Lederle Frank A FA Masaki Kamal H KH Margolis Karen L KL

Journal of the American Geriatrics Society 20121123 12

<h4>Objectives</h4>To examine the effects of vitamin D and calcium on cognitive outcomes in elderly women.<h4>Design</h4>Post hoc analysis of a randomized double-blind placebo-controlled trial.<h4>Setting</h4>Forty Women's Health Initiative (WHI) clinical centers across the United States.<h4>Participants</h4>Four thousand one hundred forty-three women aged 65 and older without probable dementia at baseline who participated in the WHI Calcium and Vitamin D Trial and the WHI Memory Study.<h4>Inter ...[more]

PMID: 23176129

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Project description:SummaryThe Women's Health Initiative (WHI) double-blind, placebo-controlled clinical trial randomly assigned 36,282 postmenopausal women in the U.S. to 1,000 mg elemental calcium carbonate plus 400 IU of vitamin D(3) daily or placebo, with average intervention period of 7.0 years. The trial was designed to test whether calcium plus vitamin D supplementation in a population in which the use of these supplements was widespread would reduce hip fracture, and secondarily, total fracture and colorectal cancer.IntroductionThis study further examines the health benefits and risks of calcium and vitamin D supplementation using WHI data, with emphasis on fractures, cardiovascular disease, cancer, and total mortality.MethodsWHI calcium and vitamin D randomized clinical trial (CT) data through the end of the intervention period were further analyzed with emphasis on treatment effects in relation to duration of supplementation, and these data were contrasted and combined with corresponding data from the WHI prospective observational study (OS).ResultsAmong women not taking personal calcium or vitamin D supplements at baseline, the hazard ratio [HR] for hip fracture occurrence in the CT following 5 or more years of calcium and vitamin D supplementation versus placebo was 0.62 (95 % confidence interval (CI), 0.38-1.00). In combined analyses of CT and OS data, the corresponding HR was 0.65 (95 % CI, 0.44-0.98). Supplementation effects were not apparent on the risks of myocardial infarction, coronary heart disease, total heart disease, stroke, overall cardiovascular disease, colorectal cancer, or total mortality, while evidence for a reduction in breast cancer risk and total invasive cancer risk among calcium plus vitamin D users was only suggestive.ConclusionThough based primarily on a subset analysis, long-term use of calcium and vitamin D appears to confer a reduction that may be substantial in the risk of hip fracture among postmenopausal women. Other health benefits and risks of supplementation at doses considered, including an elevation in urinary tract stone formation, appear to be modest and approximately balanced.

Dataset Information

Calcium and vitamin D supplementation and cognitive impairment in the women's health initiative.

Publications

Calcium and vitamin D supplementation and cognitive impairment in the women's health initiative.

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