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Jurnal Reading Geriatri

Vitamin D deficiency is associated with an increased risk of Alzheimer's disease and dementia. A meta-analysis of 10 studies found that subjects with vitamin D levels below 50 nmol/L had a 21% increased risk of Alzheimer's compared to those with higher levels. Similarly, vitamin D deficiency was linked to greater risk of dementia. While available evidence suggests low vitamin D increases the risks, more research is still needed to confirm the relationships and evaluate the benefits of vitamin D supplementation.

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Muhammad Zikri
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105 views13 pages

Jurnal Reading Geriatri

Vitamin D deficiency is associated with an increased risk of Alzheimer's disease and dementia. A meta-analysis of 10 studies found that subjects with vitamin D levels below 50 nmol/L had a 21% increased risk of Alzheimer's compared to those with higher levels. Similarly, vitamin D deficiency was linked to greater risk of dementia. While available evidence suggests low vitamin D increases the risks, more research is still needed to confirm the relationships and evaluate the benefits of vitamin D supplementation.

Uploaded by

Muhammad Zikri
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Journal Reading

“Defisiensi Vitamin D Berhubungan dengan


Peningkatan Risiko Penyakit Alzheimer dan
Demensia : Bukti berdasarkan meta analisis”

Oleh :
M. Zikri
Siti Binayu Adzani
Nindya Permata Y

Pembimbing :
dr. Hendro, Sp.S
Abstrak
• Background: In recent years, the associations between vitamin D status and Alzheimer’s
disease (AD) and dementia have gained increasing interests. The present meta-analysis was
designed to estimate the association between vitamin D deficiency and risk of developing AD and
dementia.
• Methods: A literature search conducted until February 2015 identified 10 study populations,
which were included in the meta-analysis. Pooled risk ratios (RRs) and 95 % confidence interval
(CI) were calculated with a random-effect model using Stata software package.
• Results: Results of our meta-analysis showed that subjects with deficient vitamin D status
(25(OH)D level < 50 nmol/L) were at increased risk of developing AD by 21 % compared with
those possessing 25(OH)D level > 50 nmol/L. Similar analysis also found a significantly
increased dementia risk in vitamin D deficient subjects. There is no evidence for significant
heterogeneity among the included studies.
• Conclusion: Available data indicates that lower vitamin D status may be associated with
increased risk of developing AD and dementia. More studies are needed to further confirm the
associations and to evaluate the beneficial effects of vitamin D supplementation in preventing AD
and dementia.
Pendahuluan
• Demensia Alzheimer sering terjadi pada lansia
• Prevalensi demensia alzheimer dan demensia tipe
lainnya semakin meningkat
• Pengobatan yang tepat untuk demensia alzheimer masih
belum ditemukan
• Harus mengidentifikasi faktor – faktor risiko terjadinya
gangguan tersebut
Metode
Search strategy and study selection

 Meta-analisis dilakukan sesuai dengan Pedoman PRISMA Dengan kata kunci


"penyakit Alzheimer" atau "demensia" dan "vitamin D" atau "25 (OH) D“
Pencarian literatur dilakukan di database MEDLINE dari awal hingga Februari
2015.
Kekurangan vitamin D didefinisikan sebagai serum 25 (OH) D, konsentrasi ≤ 50
nmol / L
Inklusi : studi orisinil untuk mengevaluasi hubungan status vitamin D dan risiko
pengembangan AD atau demensia; ii) memberikan odds ratios (OR), risiko relatif
(RR) atau hazard ratio (HRs) dengan interval kepercayaan 95% (CI) , referensi
dengan bahasa inggris
Eksklusi : Eksperimen hewan, review dan studi penelitian mekanistik , artikel
duplikat
Analisis data menggunakan Stata statistical software package, version 12.0
(StataCorp, College Station, Texas,USA).
Hasil
• Karakteristik penelitian
Karakteristik studi defisiensi vit D dan risiko AD
Forest plot defisiensi vit D dan risiko AD
Karakteristik studi defisiensi vit D dan risiko
demensia
Forest plot defisiensi vit D dan risiko
Demensia
Diskusi
• Sebagai hormone steroid yang larut dalam lemak, vit D
 efek mempromosikan kesehatan dan potensi efek
terapeutik pada berbagai penyakit, termasuk masalah
non skeletal dan penyakit terkait usia.
• Subjek  def vit D (25(OH)D ≤ 50 bmol/L)
• Penelitian Meta-analisis oleh Etgen dkk  subjek
dengan status vit D rendah mengalami peningkatan
risiko gangguan kognitif
• Meta-analisis Balion dkk  pasien AD dengan
konsentrasi vit D lebih rendah dibanding control.
Subjek vit D ↑ dengan skor MMSE ↑
• Penelitian meta-analisis ini didukung studi terkini
mencakup 5010 subyek dengan bebas demensia,
konsentrasi vit D ↑ berhubungan dengan risiko AD ↓
setalah 17 tahun follow up
• Namun penelitian lebih lanjut mengenai efek
suplementasi vit D dalam mencegah AD/demensia
dalam beberapa tahun terakhir  hasil tidak konsisten
• Randomised double blind placebo-controlled trial 
4143 wanita usia ≥ 65 tanpa kemungkinan demensia
 tidak ada keterkaitan antara terapi kombinasi vit D
+ CaCO3 dengan insiden gangguan kognitif
• Penetian ini  pengambilan subjek dengan jumlah
besar (perbedaan jenis kelamin, etnik, dosis vit D)
diperlukan evaluasi mengenai keterkaitan vit D dengan
AD
• Pertimbangan batasan penelitian meta-analisis :
• 1. Jumlah studi yang memenuhi syarat dalam jumlah
kecil
• 2. Insidensi AD pada pria dan wanita berbeda
• 3. Data penelitian tidak meng-exclude hubungan vit D
dengan AD/demensia yang berkembang dari penyakit
atau murni dari proses menua
Kesimpulan
• Data yang ada menunjukkan bahwa
defisiensi vitamin D dapat dikaitkan dengan
peningkatan risiko pengembangan
Alzheimer dan demensia.
• Intervensi dalam memperbaiki status
vitamin D yaitu aman dan hemat biaya, dan
harus diperhatikan dan dinilai kembali oleh
dokter spesialis saraf dan geriatri mengenai
pemberian suplemen vitamin D

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