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老年人维生素 D 状况与抑郁症状:身体机能的作用?

Vitamin D Status and Depressive Symptoms in Older Adults: A Role for Physical Functioning?

机构信息

Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.

Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

出版信息

Am J Geriatr Psychiatry. 2018 Nov;26(11):1131-1143. doi: 10.1016/j.jagp.2018.03.004. Epub 2018 Mar 12.

Abstract

OBJECTIVES

Depressive symptoms and low vitamin D status are common in older persons and may be associated, but findings are inconsistent. This study investigated whether 25-hydroxyvitamin D (25(OH)D) concentrations are associated with depressive symptoms in older adults, both cross-sectionally and longitudinally. We also examined whether physical functioning could explain this relationship, to gain a better understanding of the underlying mechanisms.

METHODS

Data from two independent prospective cohorts of the Longitudinal Aging Study Amsterdam were used: an older cohort (≥65 years, n = 1282, assessed from 1995-2002) and a younger-old cohort (55-65 years, n = 737, assessed from 2002-2009).

MEASUREMENTS

Depressive symptoms were measured at baseline and after 3 and 6 years with the Center of Epidemiological Studies Depression Scale. Cross-sectional and longitudinal linear regression techniques were used to examine the relationship between 25(OH)D and depressive symptoms. The mediating role of physical functioning was examined in the longitudinal models.

RESULTS

Cross-sectionally, associations were not significant after adjustment for confounders. Longitudinally, women in the older cohort with baseline 25(OH)D concentrations up to 75 nmol/L experienced 175 to 24% more depressive symptoms in the following 6 years, compared with women with 25(OH)D concentrations >75 nmol/L. Reduced physical performance partially mediated this relationship. In men and in the younger-old cohort, no significant associations were observed.

CONCLUSIONS

Older women showed an inverse relationship between 25(OH)D and depressive symptoms over time, which may partially be explained by declining physical functioning. Replication of these findings by future studies is needed.

摘要

目的

抑郁症状和低维生素 D 状态在老年人中很常见,两者可能有关联,但研究结果并不一致。本研究旨在调查 25-羟维生素 D(25(OH)D)浓度与老年人抑郁症状之间的关系,包括横断面和纵向研究。我们还研究了身体机能是否可以解释这种关系,以更好地了解潜在机制。

方法

本研究使用了阿姆斯特丹纵向老龄化研究的两个独立前瞻性队列的数据:一个老年队列(≥65 岁,n=1282,评估时间为 1995-2002 年)和一个年轻老年队列(55-65 岁,n=737,评估时间为 2002-2009 年)。

测量

抑郁症状在基线以及 3 年后和 6 年后使用流行病学研究中心抑郁量表进行评估。采用横断面和纵向线性回归技术,分析 25(OH)D 与抑郁症状之间的关系。在纵向模型中,研究了身体机能的中介作用。

结果

调整混杂因素后,横断面分析未见显著相关性。纵向分析中,基线时 25(OH)D 浓度在 75 nmol/L 以下的老年队列女性在随后的 6 年内出现抑郁症状的比例比 25(OH)D 浓度大于 75 nmol/L 的女性高 175%至 24%,这种相关性在女性中更为显著。身体机能的下降部分解释了这种关系。在男性和年轻老年队列中,未观察到显著的相关性。

结论

老年女性在一段时间内表现出 25(OH)D 与抑郁症状之间的负相关关系,这可能部分是由于身体机能下降所致。未来的研究需要进一步证实这些发现。

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