Archief Roodbont

Deficiencies of several vitamins, notably folate and B12, have been associated with depressive symptoms in people aged 65 and older. In this 2005 British national epidemiological household sample, investigators assessed whether low levels of serum 25-hydroxyvitamin D (25[OH]D) were associated with depressed mood in 2070 community-dwelling elders (mean age, 74; 950 men).

The overall prevalence of case-level depressive symptoms was 25.2%. Analyses were adjusted for age, sex, long-term illness, general health status, time of year (to account for sunlight variation), supplement intake, and smoking. Among the 9.8% of this population with clinically meaningful deficiency (25[OH]D levels <10>

Comment: Although these researchers examined proxies such as general health status, they did not report patients' sunlight exposure, dietary habits, or serum calcium levels. Because many mechanisms could link low serum vitamin D levels to depressive symptoms, identifying the association is only a first step. Vitamin D deficiencies in older individuals may result from inadequate sunlight exposure due to living at high latitudes or to problems with mobility or pain or both. As the authors note, other variables might include vitamin supplementation and smoking. Furthermore, low vitamin D levels may reflect the presence of hypercalcemia associated with undetected hyperparathyroidism, of which depressive features represent a classic clinical presentation. Clinicians should remember these possible contributors to depression when assessing elders.

— Joel Yager, MD

Published in Journal Watch Psychiatry August 9, 2010