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Comment & Response |

25-Hydroxyvitamin D in Patients With Cognitive Decline—Reply

Joshua W. Miller, PhD1,2; Ralph Green, MD, PhD2; Charles DeCarli, MD3
[+] Author Affiliations
1Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey
2Department of Medical Pathology and Laboratory Medicine, University of California, Davis
3Department of Neurology, University of California, Davis
JAMA Neurol. 2016;73(3):358. doi:10.1001/jamaneurol.2015.4185.
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In Reply Muratli et al raise the critical issue of whether there is a cause and effect relationship between low vitamin D status and accelerated rates of cognitive decline in older adults. We agree that dementia may lead to reduced vitamin D status owing to reduced exposure to sunlight, decreased dietary intake, and perhaps other circumstances, and therefore, reverse causation cannot be ruled out as an explanation for our results. Indeed, vitamin D status was lower on average in those participants in our study who were diagnosed as having dementia.1 However, as we stated in our report,1 we do not believe that the significant associations between low vitamin D status and rates of decline in episodic memory and executive function were due to higher prevalence of vitamin D deficiency in participants with dementia because the results remained similar after removing those participants from the statistical analysis. Importantly, participants diagnosed as having mild cognitive impairment and those considered to be cognitively normal had similar baseline vitamin D status.

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March 1, 2016
Marijn M. Speeckaert, MD, PhD; Joris R. Delanghe, MD, PhD
1Department of Nephrology, Ghent University Hospital, Ghent, Belgium
2Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium
JAMA Neurol. 2016;73(3):356-357. doi:10.1001/jamaneurol.2015.4182.
March 1, 2016
Sevilay Muratli, MD; Ozlem Soyluk, MD; Fatih Tufan
1Division of Geriatrics, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
2Department of Gerontology, Faculty of Medical Sciences, Istanbul University, Istanbul, Turkey
JAMA Neurol. 2016;73(3):357. doi:10.1001/jamaneurol.2015.4188.
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