Vitamin D and the brain: A neuropsychiatric perspective

Based on clues from epidemiology, it has been proposed that low prenatal vitamin D may be a risk factor for schizophrenia. In order to explore this hypothesis, our group has undertaken an integrated research program linking analytic epidemiology and rodent experiments. There is consistent evidence from rodents that offspring exposed to low developmental vitamin D deficiency have altered brain structure and function as adults. This chapter provides a concise summary of the evidence linking vitamin D to brain development and function. In addition, the epidemiological evidence linking hypovitaminosis D and various neuropsychiatric disorders is outlined

Vitamin D supplementation in older adults: searching for specific guidelines in nursing homes

BACKGROUND: The prevalence of vitamin D insufficiency is very high in the nursing home (NH) population. Paradoxically, vitamin D insufficiency is rarely treated despite of strong clinical evidence and recommendations for supplementation. This review aims at reporting the current knowledge of vitamin D supplementation in NH and proposing recommendations adapted to the specificities of this institutional setting. DESIGN: Current literature on vitamin D supplementation for NH residents was narratively presented and discussed by the French Group of Geriatrics and Nutrition. RESULT: Vitamin D supplementation is a safe and well-tolerated treatment. Most residents in NH have vitamin D insufficiency, and would benefit from vitamin D supplement. However, only few residents are actually treated. Current specific and personalized protocols for vitamin D supplementation may not be practical for use in NH settings (e.g., assessment of serum vitamin D concentrations before and after supplementation). Therefore, our group proposes a model of intervention based on the systematic supplementation of vitamin D (1,000 IU/day) since the patient's admission to the NH and throughout his/her stay without the need of a preliminary evaluation of the baseline levels. Calcium should be prescribed only in case of poor dietary calcium intake. CONCLUSION: A population-based rather than individual-based approach may probably improve the management of vitamin D insufficiency in the older population living in NH, without increasing the risks of adverse health problems. The clinical relevance and cost effectiveness of this proposal should be assessed under NH real-world conditions to establish its feasibility