Perfil epidemiológico de pacientes idosos com transtorno neurocognitivo e hipovitaminose D atendidos em um centro de especialidades médicas em Belém-PA

Abstract

In recent years, the associations between vitamin D status and the development of neurocognitive disorder have gained increasing relevance, mainly due to the fact that vitamin D is the only one among the vitamins that functions as a hormone. The biological actions of 1,25(OH)2 D are initiated through precise changes in genomic expression and are mediated by the intracellular vitamin D receptor (Vitamin D Receptor- VDRs) present in different parts of the body, mainly in the CNS, where performs functions such as regulation of calcium-mediated neuronal excitotoxicity, reduction of oxidative stress, production of neurotransmitters and neural trophic factors. Studies point to strong evidence that brain dysfunctions are associated with vitamin D3 insufficiency or dysfunctions of its receptors. The objective of the present study was to describe the epidemiological profile of elderly patients diagnosed with Neurocognitive Disorder, treated at the Centro de Especialidades Médicas do Cesupa (CEMEC), with Hypovitaminosis D and to analyze the association of low vitamin D and cognitive decline in these individuals. A descriptive and analytical cross-sectional observational study was carried out based on the analysis of data from medical records of patients diagnosed with neurocognitive disorder and hypovitaminosis D from January 2017 to March 2022. In the analyzed sample, a prevalence was identified female, the age of the participants ranged from 61 to 105 years, 76.8% were brown, 35.4% were widowed, more than half had completed/incomplete elementary school and 88.9% had no data on the profession. Regarding serum levels of vitamin D, the values ranged between 3.4 and 78 ng/ml, with a mean of 28.5 ng/ml (± 12.1 ng/ml), most with a value <30ng/ml ( 63.6%). In addition, regarding the neurocognitive disorder associated with hypovitaminosis D, the most prevalent was mild cognitive impairment with 36.4%. In this study, it was not possible to statistically identify a direct association between the epidemiological profile of the elderly diagnosed with´´ neurocognitive disorder and hypovitaminosis D, however, the research found limitations related to the small number of participants selected in the sample and it may not represent the general population of the elderly, and it is difficult to determine the causal relationship with vitamin D deficiency as a risk factor for accelerating cognitive decline or as a consequence of an installed neurocognitive disorder. Thus, it is of fundamental importance to establish studies with a larger sample, in order to guarantee statistical relevance.