Connection between Vitamin D deficiency and neurological conditions

Vitamin D

Dementia is a syndrome usually progressive and chronic in nature. Global incidences of dementia is increasing at a rate of one new case every three seconds with associated medical social and health care costs far exceeding the capacity of most countries. Because of the degenerative nature of the disease sufferers lose their ability to perform routine tasks, experience poor quality of life and loss of autonomy. The role of vitamin D in the etiology of cognitive impairment and dementia is plausible and has been supported substantial mechanistic and epidemiological data. As people age, they tend to spend less and less time outdoors in the sun. It is of great importance as vitamin D deficiency is a worldwide pandemic and is seen most commonly in older adults residing in northerly latitudes, particularly during winter months. Further research needs to be done to see if increasing vitamin D level will improve cognitive health (Aspell, Lawlor, O'Sullivan, 2018).

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Vitamin D connection with neurological issues
Depression is a common condition among the elderly. Older adults with depressive symptoms face multiple adverse health issues such as functional decline, cognitive impairment, disability, decreased quality of life, and increased mortality from co-occurring medical conditions and suicide. Vitamin D plays an important role in physical and mental health. It regulates more than 200 genes and is responsible for neural and musculoskeletal health. The Chinese study showed an association between vitamin D status and depression among long-lived persons.

The mechanism through which vitamin D plays a beneficial role in mental health has not been clearly understood. Vitamin D deficiency has been shown to be prevalent world wide among older populations. Prevention of vitamin D deficiency may become a future strategy to prevent depression. In addition, normalization of vitamin D levels may now be an integral part of depression treatment in the very old (Yao et al, 2018).

What does vitamin D do in the body
Vitamin D helps with regulation of neurotropin, neural differentiation and maturation through the control operation of growing factors synthesis. Due to the lack of effective therapeutic options, the role of different risk factors should be investigated in neurology. Low levels have already been linked to health problems worldwide, including non-skeletal functions such as hypertension, diabetes, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease and stroke. Vitamin D is a lipid soluble vitamin that can be synthesized and acts like a hormone. Calcitriol, an active form of vitamin D, is chemically similar to testosterone, estrogen, and cortisol. Little is known about re-myelination and the role of vitamin D. Since the 1970’s multiple sclerosis has been linked to vitamin D deficiency. Studies have found this to be a disease basically unknown at the equator. As researchers move further north or south of the equator, prevalence of multiple sclerosis increases. In addition cases increase at higher latitudes and peaks in areas with lowest exposure to the sun’s ultraviolet light. Many studies have found that supplementing vitamin D may benefit Multiple sclerosis patients.

However, in the medical community there is differing opinions as to what are the acceptable levels patients should have. The Institute of Medicine said level greater than 20ng/ml is sufficient. Endocrine society considering both skeletal and non-skeletal health has argued for 30ng/ml. And in the field treating Multiple sclerosis patients multiple studies have shown 40ng/ml was the minimum value that should be given (Moretti et al, 2018).

Vitamin D is vital for our body as it regulates calcium homeostatisis, maintains bone integrity and studies have shown there are other factors linked to adequate levels of vitamin D. it also has a vital role in neurodevelopment and function. Primary source of vitamin D is from sunlight-ultraviolet rays. It can also be obtained by eating a few foods such as oily fish and fortified margarine.

Effects to body when levels are low
Recent studies have found vitamin D is being recognized as a necessary neuro-steroid with various actions in the brain. There have been many studies done that show a link between depression and low vitamin D levels. This is due in part by a change in the hippocampus indicative of depression and found in people with low vitamin D levels. In addition, results have been seen that prenatal nutrition needs to include vitamins A + D in order to decrease risk of schizophrenia or other mental health illnesses later in life for the child. It has also been linked to depression, dementia, and autism in addition to schizophrenia in the offspring (Ajnum et al. 2018).
Rickets is a disease of childhood that occurs due to failure of regulated chondrocyte apoptosis and deficient mineralization at the growth plates of the long bones. Worldwide the most common cause for this disease is vitamin D deficiency. In tropical and subtropical areas there is generally enough access to sunlight, however, malnutrition can just nullify the benefits of the sun. vitamin D appeared to play an important role in prevention of rickets. In addition the levels of calcium, potassium, and vitamin D was likely to be linked to the overall poverty which could be directly linked to food security and nutritional intake (Jones et al, 2018).

The group undertreated for low vitamin D
Small amounts of vitamin D is obtained from food. Its main natural source is produced in the skin when the person is exposed to sunlight. This explains in part why the elderly may have low vitamin D levels. Problems with decreased mobility, physiologic atrophy and malnutrition can all be a factor in low vitamin D levels. The Institute of Medicine recommends 20ng/ml as sufficient vitamin D in the general population. The prevalence of this vitamins deficiency is generally considered to be high among the elderly. Due to this, previous studies have seen insufficiency in hospitalized older patients. The study found there was a link between depression and vitamin D deficiency . There was also demonstration of vitamin D having an impact on various neurotransmitter targets. Almost 96% of the group studied was found to have deficit of this vitamin. Their recommendation was that testing vitamin D levels should be used to monitor supplementation with this vitamin to help with depression prior to starting antidepressents medications in the elderly (Boettger, et al., 2018).

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Conclusion
Prevalence of vitamin D deficiency is greater in certain clinical subpopulations. Presence of associated characteristics should lead to a higher suspicion in regard to conditions associated with vitamin D deficiency such as osteoporosis and osteomalagia (achy bones). And while there are differing opinions about optimal level of vitamin D in the body, most experts feel levels should be 20-30ng/ml, growing scientific evidence has implicated vitamin D deficiency in a multitude of chronic disorders including rheumatoid arthritis, asthma lack of control, hypertension, cardiovascular disease, and mental health issues. This study supported established connection between hypovitaminosis D and other health conditions. It also showed that daily consumption of fortified milk products can be an effective prophylaxis against vitamin D deficiency. More studies need to be done to correlate the effects of age on vitamin D deficiency (Parva et al, 2018).

Works Cited
Anjum, I. et al. (2018). The role of Vitamin D in brain health: A mini literature review. Cureus, 10(7).

Aspell,N., Lawlor,B., & O’Sullivan, M. (2018). Is there a role for Vitamin D in supporting cognitive function as we age? Proceedings of the Nutrition Society.

Boettger, S.F. et al. (2018). Prevalence and predictors of Vitamin D-deficiency in frail older hospitalized patients. BMC Geriatrics, 18(219).

Jones, K.D.J. et al. (2018). Vitamin D deficiency causes rickets in urban informal settlements in Kenya and is associated with malnutrition. Maternal & Child Nutrition.

Moretti, R. et al. (2018). Vitamin D in neurological diseases: A rational for a pathogenic impact. International Journal of Molecular Sciences, 14(8).

Parva, N.R. et al. (2018). Prevalence of vitamin D deficiency and associated risk factors in the US population (2011-2012). Cureus, 10(6).

Yao,Y et al. (2018). The prevalence of depressive symptoms in Chinese longevous persons and its correlation with vitamin D status. BMC Geriatrics, 18(198).

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