levels in blood and risk for autism. Three lower-quality observational studies were identified for further consideration: one retrospective chart review, one small cohort from a developing country, and one cross–sectional study. A recent study in Sweden that retrospectively reviewed serum 25OHD levels from medical records of out-patients receiving psychiatric care, including autism, suggested a high prevalence of vitamin D insufficiency in psychiatric outpatients (Humble et al., 2010). Although the study did not include matched controls, comparisons made with previously published samples from healthy Swedish populations suggested that the prevalence of vitamin D insufficiency was greater in the population receiving psychiatric care. The study, however, did not take into account dietary intake of vitamin D. Fernell and Gillberg (2010) tested the association between serum 25OHD levels and prevalence of autism in an analysis of a small cohort of mothers of children with autism from Somalia and Sweden, but they found no statistically significant differences in serum 25OHD levels between either group of mothers and controls.

Herndon et al. (2009), in a cross–sectional study, examined associations between vitamin D and calcium in dairy foods and autism. This study found that children with autism spectrum disorders consumed less calcium and fewer servings of dairy foods compared with children with typical development. Interpretation of this evidence for an association between vitamin D measures and risk for autism, however, is confounded by other potential factors that could influence vitamin D measures.

Concluding statement Owing to the lack of causal evidence from RCTs and a paucity of evidence, as well as a lack of data from large, prospective cohort studies and inconsistent findings for an association between vitamin D and incidence of autism from largely cross–sectional observational studies, autism was not considered further as an indicator for DRI development.

Loss of cognitive function in the form of dementia is frequently associated with aging. Between the ages of 60 and 85, the prevalence of dementia in the general population increases from 1 to 40 percent (Bolla et al., 2000). Dementia is classified into four major subtypes: Alzheimer’s disease, Lewy body dementia, frontotemporal dementia, and vascular dementia (Bolla et al., 2000; Grossman et al., 2006). Vitamin D has been hypothesized to confer neuroprotective effects and reduce the risk for developing dementia (Buell and Dawson-Hughes, 2008; McCann and Ames, 2008).

Biological plausibility Vitamin D has been proposed to prevent cognitive decline, and plausible biological mechanisms support this hypothesis. Vitamin D may protect against cognitive decline by promoting vascular health