The Impact of Vitamin D Deficiency on Cognitive and Neuromuscular Functions in Elderly Patients
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Bibliographic record
Abstract
Background/Aims: Vitamin D plays an important regulatory role in neuronal and neuromuscular signalling, partly through its effects on calcium homeostasis, neuroinflammatory pathways, and vitamin D receptor–mediated transcription in neurons and glial cells. Deficiency of vitamin D is common among older adults and has been associated with impaired cognitive performance, reduced neuromuscular function, and elevated inflammatory activity. However, its relationship with neurocognitive and neuromuscular signalling deficits in aging populations remains insufficiently characterized. To investigate the associations between serum 25-hydroxyvitamin D [25(OH)D] levels, cognitive performance, neuromuscular function, and inflammatory signalling markers in older adults, and to explore whether altered calcium metabolism or inflammatory activation may contribute to these functional impairments. Methods: A cross-sectional study was conducted over six months (March–August 2025) at Tikrit Teaching Hospital, enrolling 250 adults aged 65–85 years via systematic random sampling. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Neuromuscular performance was evaluated by handgrip strength, gait speed, Timed Up and Go (TUG) testing, bioelectrical impedance analysis, and electromyography (EMG) to detect abnormalities in neuromuscular transmission. Serum 25(OH)D, calcium, phosphorus, parathyroid hormone (PTH), alkaline phosphatase, creatine kinase, C-reactive protein (CRP), and interleukin-6 (IL-6) were measured. Associations between vitamin D status and functional or biochemical outcomes were examined using Pearson correlations and group comparisons (p < 0.05 considered significant). Results: Vitamin D deficiency was highly prevalent (62.0%), with 23.2% showing insufficiency and 14.8% sufficient levels. Lower 25(OH)D concentrations were associated with reduced MMSE and MoCA scores, weaker handgrip strength, slower gait speed, prolonged TUG times, decreased skeletal muscle mass, and a higher frequency of EMG abnormalities indicative of impaired neuromuscular signalling. Deficient participants showed significantly lower calcium and higher PTH, CRP, and IL-6 levels, reflecting disturbances in calcium regulation and heightened inflammatory signalling. Pearson correlation coefficients (r = 0.30–0.62) demonstrated moderate positive associations between 25(OH)D and cognitive and neuromuscular performance, and negative associations with TUG time and inflammatory biomarkers. Conclusion: Vitamin D deficiency in older adults is associated with impaired cognitive function and neuromuscular performance, potentially mediated by dysregulated calcium signalling and increased neuroinflammatory activity. These findings support a mechanistic link between vitamin D status and neuronal as well as neuromuscular communication pathways. Longitudinal and interventional studies are needed to clarify causality and determine whether vitamin D optimization may help preserve neurocognitive and neuromuscular function in aging populations.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it