Among Black participants (19%), those assigned vitamin D3 versus placebo had better cognitive maintenance (MD = 0.04, 95% CI 0.01, 0.08, similar to that observed for Black participants 1.2 years apart in age).
We observed no interaction with baseline 25-hydroxyvitamin-D levels (p-interaction = 0.84) and a significant interaction with self-reported race (p-interaction = 0.01). The pooled mean difference in annual rate of decline (MD) for vitamin D3 versus placebo was 0.01 (95% CI − 0.01, 0.02 p = 0.39). The primary, pre-specified outcome was decline over two assessments in global composite score (average z-scores of all tests) substudy-specific results were meta-analyzed. We included participants aged 60+ years (mean = 70.9 years) free of cardiovascular disease and cancer in two substudies in the VITAL 2 × 2 randomized trial of vitamin D3 (2000 IU/day of cholecalciferol) and fish oil supplements: 3424 had cognitive assessments by phone (eight neuropsychologic tests 2.8 years follow-up) and 794 had in-person assessments (nine tests 2.0 years follow-up). In a trial, we evaluated vitamin D3 supplementation on cognitive decline. Low vitamin D levels have been associated with cognitive decline however, few randomized trials have been conducted.
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