Vitamin D context

There’s a story in the Herald about Alzheimer’s Disease risk being much higher in people with low vitamin D levels in their blood. This is observational data, where vitamin D was measured and the researchers then waited to see who would get dementia. That’s all in the story, and the problems aren’t the Herald’s fault.

The lead author of the research paper is quoted as saying

“Clinical trials are now needed to establish whether eating foods such as oily fish or taking vitamin D supplements can delay or even prevent the onset of Alzheimer’s disease and dementia.”

That’s true, as far as it goes, but you might have expected the person writing the press release to mention the existing randomised trial evidence.

The Women’s Health Initiative, one of the largest and probably the most expensive randomised trial ever, included randomisation to calcium and vitamin D or placebo. The goal was to look at prevention of fractures, with prevention of colon cancer as a secondary question, but they have data on dementia and they have published it

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 [mild cognitive impairment] (HR = 0.95, 95% CI = 0.72-1.25, P = .72). There were no significant differences in incident dementia or [mild cognitive impairment] or in global or domain-specific cognitive function between groups.. 

That’s based on roughly 2000 women in each treatment group.

The Women’s Health Initiative data doesn’t nail down all the possibilities. It could be that a higher dose is needed. It could be that the women were too healthy (although half of them had low vitamin D levels by usual criteria). The research paper mentions the Women’s Health Initiative and these possible explanations, so the authors were definitely aware of them.

If you’re going to tell people about a potential way to prevent dementia, it would be helpful to at least mention that one form of it has been tried and didn’t work.