Vitamine D en depressies*
Ouderen met lage bloedwaarden vitamine D lopen veel meer kans op een
depressie dan zij met goede bloedwaarden vitamine D volgens een studie onder een kleine duizend mannen en vrouwen van 65 jaar en ouder. Aan het begin van de zesjarige studie had ¾ van de vrouwen en de helft van de mannen bloedwaarden vitamine D lager dan 20 ng/ml. Deelnemers, vooral de vrouwen, hadden bij lage bloedwaarden vitamine D wel twee keer meer kans om binnen die zes jaar een depressie te krijgen dan de deelnemers met goed bloedwaarden. Lagere bloedwaarden zorgden ook voor meer stemmingswisselingen bij de deelnemers.
Low vitamin D tied to depression in older people
Older men and women with lower levels of vitamin D in their blood are more prone to become depressed over time, new research shows.
Many studies have been published recently on the potential health benefits of vitamin D, and the potential risks of deficiency. Low vitamin D levels have been linked to heart disease, stroke, high blood pressure, and more severe asthma.
In older people, insufficient vitamin D is quite common, and has been linked to fractures, worse physical function, greater frailty, and a wide variety of chronic illness.
In the current study, Dr. Luigi Ferrucci of the National Institute on Aging in Baltimore and colleagues looked at whether low vitamin D levels and depression in older people might be related.
They followed 531 women and 423 men 65 and older who were participating in the InCHIANTI Study, a long-term investigation of factors associated with loss of mobility in aging people, over six years.
At the study's outset, 42 percent of the women and 18 percent of the men were depressed, while three-quarters of the women and half of the men had levels of vitamin D below 50 nanomoles per liter, which is generally considered insufficient.
Seventy-two percent of the depressed people and 60 percent of the non-depressed people had vitamin D insufficiency - the level above deficiency -- the researchers found. Women with vitamin D insufficiency showed a worse decline in mood at three and six years into the study; their scores on a standardized test measuring depressive symptoms increased more at three and six years compared to the scores for women who had adequate vitamin D. This increase could have tipped the scale into a diagnosis of depression for some people.
Women with low vitamin D who weren't depressed at the beginning of the study were also twice as likely to become depressed over the following six years as the women who had sufficient levels of the nutrient. While similar patterns were seen for men, the association wasn't as strong, and in some cases could have been due to chance, according to the researchers.
The study does not prove that low vitamin D levels cause depression, the authors note; people with low levels of the nutrient might have other characteristics that predispose them to the blues.
Still, they suggest that preventing "vitamin D deficiency in the elderly may become in the future a strategy to prevent the development of depressive mood in the elderly and avoid its deleterious consequences on health. In addition, normalization of vitamin D levels may be part of any depression treatment plans in older patients."
Vitamin D, produced by the body when skin is exposed to sunlight, is also found in certain foods such as oily fish. It helps cells absorb calcium and is important for bone health.
However, the authors conclude, before any strategies to boost vitamin D can be adopted they must be tested in larger and more rigorously designed trials.
Abstract
Serum 25-Hydroxyvitamin D and Depressive Symptoms in Older Women and Men
Yuri Milaneschi, Michelle Shardell, Anna Maria Corsi, Rosamaria Vazzana, Stefania Bandinelli, Jack M. Guralnik, and Luigi Ferrucci*
Longitudinal Studies Section (Y.M., L.F.), Clinical Research Branch, National Institute on Aging, Baltimore, Maryland 21225; Laboratory of Epidemiology Demography and Biometry (J.M.G.), National Institute on Aging, Bethesda, Maryland 20892; Department of Epidemiology and Preventive Medicine (M.S.), University of Maryland School of Medicine, Baltimore, Maryland 21201; Tuscany Health Regional Agency (A.M.C.), 50134 Florence, Italy; Department of Medicine and Sciences of Aging (R.V.), Laboratory of Clinical Epidemiology, University "G. D'Annunzio" of Chieti, 66100 Chieti, Italy; and Geriatric Unit (S.B.), Azienda Sanitaria Firenze, 50125 Florence, Italy
* To whom correspondence should be addressed. E-mail: ferruccilu@grc.nia.nih.gov
Context: Hypovitaminosis D and depressive symptoms are common conditions in older adults.
Objective: We examined the relationship between 25-hydroxyvitamin D [25(OH)D] and depressive symptoms over a 6-yr follow-up in a sample of older adults.
Design and Setting: This research is part of a population-based cohort study (InCHIANTI Study) in Tuscany, Italy.
Participants: A total of 531 women and 423 men aged 65 yr and older participated.
Main Outcome Measure: Serum 25(OH)D was measured at baseline. Depressive symptoms were assessed at baseline and at 3- and 6-yr follow-ups using the Center for Epidemiological Studies-Depression Scale (CES-D). Depressed mood was defined as CES-D of 16 or higher. Analyses were stratified by sex and adjusted for relevant biomarkers and variables related to sociodemographics, somatic health, and functional status.
Results: Women with 25(OH)D less than 50 nmol/liter compared with those with higher levels experienced increases in CES-D scores of 2.1 (P = 0.02) and 2.2 (P = 0.04) points higher at, respectively, 3- and 6-yr follow-up. Women with low vitamin D (Vit-D) had also significantly higher risk of developing depressive mood over the follow-up (hazard ratio = 2.0; 95% confidence interval = 1.2-3.2; P = 0.005). In parallel models, men with 25(OH)D less than 50 nmol/liter compared with those with higher levels experienced increases in CES-D scores of 1.9 (P = 0.01) and 1.1 (P = 0.20) points higher at 3- and 6-yr follow-up. Men with low Vit- D tended to have higher risk of developing depressed mood (hazard ratio = 1.6; 95% confidence interval = 0.9-2.8; P = 0.1).
Conclusion: Our findings suggest that hypovitaminosis D is a risk factor for the development of depressive symptoms in older persons. The strength of the prospective association is higher in women than in men. Understanding the potential causal pathway between Vit- D deficiency and depression requires further research. (Mei 2010)
