Sleep

Serum 25-hydroxyvitamin D concentrations, sleep characteristics and the risk of incident dementia.

TL;DR

Serum 25-hydroxyvitamin D concentrations were inversely associated with the risks of all-cause dementia, Alzheimer's disease and vascular dementia, and sleep characteristics, particularly daytime sleepiness, may modify the association between serum 25-hydroxyvitamin D concentrations and the risk of vascular dementia.

Key Findings

Higher serum 25-hydroxyvitamin D concentrations were associated with a lower risk of all-cause dementia over a median follow-up of 13.7 years.

  • The study included 366,160 participants in a prospective population-based cohort design.
  • There were 7,030 cases of all-cause dementia recorded during the follow-up period.
  • A multivariable adjusted Cox proportional hazards regression model was used to evaluate the association.
  • The inverse association was observed after adjusting for multiple covariates.

Higher serum 25-hydroxyvitamin D concentrations were associated with a lower risk of Alzheimer's disease.

  • There were 3,089 cases of Alzheimer's disease in the cohort over the median follow-up of 13.7 years.
  • The association was evaluated using multivariable adjusted Cox proportional hazards regression.
  • The cohort consisted of 366,160 participants.

Higher serum 25-hydroxyvitamin D concentrations were associated with a lower risk of vascular dementia.

  • There were 1,539 cases of vascular dementia in the cohort during follow-up.
  • The inverse association was identified using multivariable adjusted Cox proportional hazards regression.
  • The median follow-up period was 13.7 years across 366,160 participants.

A statistically significant interaction of modest magnitude was found between serum 25-hydroxyvitamin D concentrations and overall sleep patterns on the risk of vascular dementia.

  • The interaction p-value was 0.04 (P interaction = 0.04).
  • Sleep characteristics including sleep duration, chronotype, sleeplessness, snoring, and daytime sleepiness were integrated to generate an overall sleep pattern.
  • The interaction was described as being of 'modest magnitude.'

Daytime sleepiness specifically modified the association between serum 25-hydroxyvitamin D concentrations and the risk of vascular dementia.

  • The interaction between serum 25-hydroxyvitamin D concentrations and daytime sleepiness on vascular dementia risk was statistically significant (P interaction = 0.03).
  • The protective hazard ratios for vascular dementia were more pronounced in individuals with low daytime sleepiness than in those with high daytime sleepiness.
  • Among all sleep characteristics examined, daytime sleepiness was the specific component driving the interaction.

The study used an integrated overall sleep pattern score derived from five distinct sleep characteristics.

  • The five sleep characteristics included were: sleep duration, chronotype, sleeplessness, snoring, and daytime sleepiness.
  • These characteristics were combined to generate an overall sleep pattern variable.
  • This sleep pattern variable was used to test for interaction with serum 25-hydroxyvitamin D concentrations.

What This Means

This research suggests that people with higher levels of vitamin D in their blood are less likely to develop dementia — including Alzheimer's disease and vascular dementia — over time. The study followed over 366,000 people for nearly 14 years and found more than 7,000 cases of dementia, making it a large and long-term investigation. The researchers accounted for many other factors that could explain the relationship, strengthening the case for a genuine association between vitamin D levels and dementia risk. The study also looked at whether sleep habits changed this relationship. Researchers examined five aspects of sleep — how long people sleep, whether they are morning or evening types, difficulty sleeping, snoring, and daytime sleepiness — and combined them into an overall sleep pattern score. They found that sleep patterns, and daytime sleepiness in particular, appeared to influence how strongly vitamin D levels were linked to vascular dementia risk. Specifically, higher vitamin D levels seemed to offer more protection against vascular dementia in people who did not feel excessively sleepy during the day compared to those who did. This research suggests that both vitamin D status and sleep quality may play roles in brain health and dementia risk, and that these factors may interact with each other. The findings point to the potential importance of monitoring and addressing both vitamin D levels and sleep characteristics, particularly daytime sleepiness, in the context of dementia prevention research. However, as an observational study, it cannot prove that vitamin D directly prevents dementia or that improving sleep will change outcomes.

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Citation

Ren J, Li Z, Zhong W, Gao J, Chen P, Wang X, et al.. (2026). Serum 25-hydroxyvitamin D concentrations, sleep characteristics and the risk of incident dementia.. Maturitas. https://doi.org/10.1016/j.maturitas.2026.108864