The Irish Longitudinal Study on Aging, Trinity College Dublin, Dublin, Ireland; Mercer's Institute for Successful Aging, St James's Hospital, Dublin, Ireland.
Mercer's Institute for Successful Aging, St James's Hospital, Dublin, Ireland.
J Am Med Dir Assoc. 2019 May;20(5):517-523. doi: 10.1016/j.jamda.2018.10.006. Epub 2018 Nov 20.
To examine the prospective relationship between vitamin D status and incident depression in a large cohort of nondepressed community-dwelling older people.
Longitudinal study examining the relationship between vitamin D levels at baseline (wave 1) and incident depression at 2 and 4 years (waves 2 and 3), embedded within the Irish Longitudinal Study on Aging. Participants with depression at wave 1 were excluded. Logistic regression models reporting odds ratios were used to analyze the longitudinal association of vitamin D categories with incident depression. Analysis was weighted for attrition.
Almost 4000 community-dwelling people aged ≥50 years.
A score ≥9 on the Center for Epidemiologic Studies Depression Scale-8 at wave 2 or 3 was indicative of incident depression. Vitamin D analysis was performed using liquid chromatography-tandem mass spectrometry and deficiency, insufficiency, and sufficiency were defined as <30, 30-50, and >50 nmol/L, respectively.
The incident depression group (400/3965) had a higher likelihood of baseline vitamin D deficiency (proportional estimation 19.4) [95% confidence interval (CI) 15.1-24.7] vs [12.4 (95% CI 11.1-14.0); Z = 3.93; P < .001]. Logistic regression models demonstrated that participants with vitamin D deficiency had a significantly higher likelihood of incident depression (odds ratio 1.75, 95% CI 1.24-2.46; t = 3.21; P = .001). This finding remained robust after controlling for relevant covariates including physical activity, chronic disease burden, cardiovascular disease and antidepressant use.
CONCLUSIONS/IMPLICATIONS: This study demonstrates that vitamin D deficiency is associated with a significant increase in the likelihood of developing depression in later life. These findings are important, given the high prevalence of vitamin D deficiency among older people, the fact that supplementation has a low risk of toxicity or side effects, as well as the significant adverse effect depression can have on functional status and longevity in later life.
在一个大型非抑郁社区居住的老年人队列中，研究维生素 D 状况与抑郁发生之间的前瞻性关系。
这项纵向研究通过纳入爱尔兰老龄化纵向研究，在基线（第 1 波）时检查维生素 D 水平与 2 年和 4 年（第 2 波和第 3 波）时发生抑郁之间的关系。第 1 波时患有抑郁的参与者被排除在外。使用报告比值比的逻辑回归模型分析维生素 D 类别与发生抑郁的纵向关联。分析考虑了损耗的权重。
近 4000 名年龄≥50 岁的社区居住者。
第 2 波或第 3 波时，使用中心流行病学研究抑郁量表-8 评分≥9 表明发生了抑郁。使用液相色谱-串联质谱法进行维生素 D 分析，分别将<30、30-50 和>50nmol/L 定义为缺乏、不足和充足。
抑郁发生组（400/3965）基线维生素 D 缺乏的可能性更高（比例估计值 19.4）[95%置信区间（CI）15.1-24.7]与[12.4（95%CI 11.1-14.0）；Z=3.93；P<.001]。逻辑回归模型表明，维生素 D 缺乏的参与者发生抑郁的可能性显著更高（优势比 1.75，95%CI 1.24-2.46；t=3.21；P=.001）。在控制了包括体力活动、慢性疾病负担、心血管疾病和使用抗抑郁药在内的相关协变量后，这一发现仍然成立。
结论/意义：这项研究表明，维生素 D 缺乏与晚年发生抑郁的可能性显著增加有关。鉴于老年人中维生素 D 缺乏的高患病率、补充剂的毒性或副作用风险低以及抑郁对晚年功能状态和寿命的显著不利影响，这些发现非常重要。
