Vitamin K and cognition in the elderly

The Relationships Between Vitamin K and Cognition: A Review of Current Evidence - May 2019

Front Neurol. 2019 Mar 19;10:239. doi: 10.3389/fneur.2019.00239. eCollection 2019.
Alisi L1, Cao R2, De Angelis C3, Cafolla A4, Caramia F5, Cartocci G5, Librando A1, Fiorelli M5.

Vitamin K is a fat-soluble nutrient discovered in 1935 and its role in blood coagulation has been thoroughly explored. In recent years, studies conducted in vitro and on animals highlighted vitamin K involvement in brain cells development and survival. In particular, vitamin K seems to have an antiapoptotic and anti-inflammatory effect mediated by the activation of Growth Arrest Specific Gene 6 and Protein S. Moreover, this vitamin is involved in sphingolipids metabolism, a class of lipids that participate in the proliferation, differentiation, and survival of brain cells. An altered expression in sphingolipids profile has been related to neuroinflammation and neurodegeneration. This review stems from a growing interest in the role of vitamin K in brain functions, especially in cognition, also in view of an expected increase of prevalence of Alzheimer's disease and other forms of dementia. It collects recent researches that show interesting, even though not definitive, evidence of a direct correlation between vitamin K levels and cognitive performance. Moreover, vitamin K antagonists, used worldwide as oral anticoagulants, according to recent studies may have a negative influence on cognitive domains such as visual memory, verbal fluency and brain volume. The aim of this review is to analyze the evidence of clinical studies carried out up to date on the relationship between vitamin K intake and cognitive performances. The involvement of vitamin K antagonists (VKAs) in declining cognitive performances is also addressed separately.
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Dietary Vitamin K Intake Is Associated with Cognition and Behaviour among Geriatric Patients: The CLIP Study - 2015

Nutients 2015, 7(8), 6739-6750; doi:10.3390/nu7085306 (registering DOI)
Justine Chouet 1, Guylaine Ferland 2, Catherine Féart 3,4, Yves Rolland 5, Nancy Presse 2, Kariane Boucher 2, Pascale Barberger-Gateau 3,4, Olivier Beauchet 1 and Cedric Annweiler 1,6,*
1 Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital Angers University Memory Clinic; UPRES EA 4638, University of Angers, UNAM, Angers F-49933, France
2 Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
3 Université Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux F-33000, France
4 INSERM, ISPED, INSERM_U897-Epidemiologie-Biostatistique, Bordeaux F-33000, France
5 Department of Geriatric Medicine, Institut du Vieillissement, University Hospital INSERM U1027, Toulouse F-31400, France
6 Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, ON N6A 5B7, Canada
* Author to whom correspondence should be addressed.
Received: 15 June 2015 / Revised: 16 July 2015 / Accepted: 24 July 2015 / Published: 12 August 2015
(This article belongs to the Special Issue Vitamin K and Vitamin K-Dependent Proteins in Relation to Human Health)

Our objective was to determine whether dietary vitamin K intake was associated with cognition and behavior among older adults. 192 consecutive participants ≥65 years, recruited in the cross-sectional CLIP (Cognition and LIPophilic vitamins) study, were separated into two groups according to the tertiles of dietary phylloquinone intake (i.e., lowest third below 207 µg/day versus the other two thirds combined). Daily dietary phylloquinone intake was estimated from 50-item interviewer-administered food frequency questionnaire. Cognition was assessed with Mini-Mental State Examination (MMSE); behaviour with Frontotemporal Behavioral Rating Scale (FBRS). Age, gender, social problems, education, body mass index (BMI), comorbidities, history of stroke, use vitamin K antagonists, inadequate fatty fish intake, serum thyroid-stimulating hormone (TSH), vitamin B12, albumin, and estimated glomerular filtration rate were used as confounders. Compared to participants in the lowest third of dietary phylloquinone intake (n = 64), those with higher intake had higher (i.e., better) mean MMSE score (22.0 ± 5.7 versus 19.9 ± 6.2, p = 0.024) and lower (i.e., better) FBRS score (1.5 ± 1.2 versus 1.9 ± 1.3, p = 0.042). In multivariate linear regressions, log dietary phylloquinone intake was positively associated with MMSE score (adjusted β = 1.66, p = 0.013) and inversely associated with FBRS score (adjusted β = −0.33, p = 0.037). Specifically, log dietary phylloquinone intake correlated negatively with FBRS subscore of physical neglect (r = −0.24, p = 0.001). Higher dietary phylloquinone intake was associated with better cognition and behavior among older adults.
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Use of drugs which block Vitamin K was associated with 17X increase in cognitive imparement - 2015

Vitamin K antagonists and cognitive impairment: results from a cross-sectional pilot study among geriatric patients.
J Gerontol A Biol Sci Med Sci. 2015 Jan;70(1):97-101. doi: 10.1093/gerona/glu133. Epub 2014 Aug 23.
Annweiler C 1, Ferland G2, Barberger-Gateau P3, Brangier A4, Rolland Y5, Beauchet O4.

BACKGROUND:
Vitamin K is involved in brain physiology, suggesting that its deficiency induces cognitive decline. Our objective was to determine whether using vitamin K antagonists (VKAs) was associated with cognitive impairment among geriatric patients.

METHODS:
Two hundred sixty-seven older patients (mean, 83.4 ± 8.1 years; 56.9% female) were categorized according to cognitive impairment (ie, Mini-Mental State Examination ≤ 25). The regular use of VKAs was sought by questioning the patients, relatives, and family physicians. Age, gender, body mass index, comorbidity burden, mood and executive functioning, history of atrial fibrillation, ischemic stroke, intracranial hemorrhage and transient ischemic attack, use of other anticoagulants and antiplatelet medications, and severe renal failure were used as potential confounders.

RESULTS:
Compared with participants without cognitive impairment (n = 70), those with Mini-Mental State Examination ≤ 25 used more frequently VKAs (p = .038). The risk of cognitive impairment was 15% higher with VKAs, specifically with fluindione. Using VKAs was independently associated with cognitive impairment (fully adjusted odds ratio = 17.4 [95% CI: 1.4-224.2], p = .028).

CONCLUSIONS:
We found more frequent cognitive impairment associated with the use of VKAs, specifically fluindione, among geriatric patients.

PMID: 25151653

Note Vitamin K1 ==> Vitamin K2only if your gut bacteria are working properly

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