Older Adults, Depression and Vitamin D

A new study has found that vitamin D deficiency may affect mental health in older adults regarding depression.

Nutrition for Optimal Wellness | Greg Arnold, DC, CSCS | Vitamin D has been known for more than 80 years to benefit bone health since it was discovered to cure rickets¹. But vitamin D’s health benefits also encompass heart health², prostate health³, mental neurological health⁴ and even improving long-term health⁵.

Current recommendations by the National Institutes of Health are still 200 IU for people up to 50 years of age, 400 IU for people 51-70 years, and 600 IU for 71 years and older⁶. But vitamin D’s role in health has caused the American Academy of Pediatrics to recommend doubling the intake for children to 400 IU per day⁷. Now a new study⁸ has found that vitamin D deficiency may affect mental health in older adults regarding depression. Major depressive disorder is the leading cause of disability in the U.S. for ages 15-44⁹, affecting nearly 15 million American adults each year, which is nearly 7 percent of the U.S. population aged 18 and older¹⁰. Major depressive disorder is a significant contributor to the $83 billion cost of depression to our healthcare system each year¹¹.

In the study, 531 women and 423 men 65 years of age and older provided blood samples before the study began and at 3 and 6 years while completing the Center for Epidemiological Studies Depression Scale (CES-D)¹². The CES-D is a 20-item self-report scale, ranging from 0 to 60 that has been shown to accurately assess depressive symptoms in older adults¹³. According to the CES-D, a “depressed mood” is defined as having a score of 16 or higher. The researchers chose to use 50 nanmoles/Liter as the reference point, with the National Institute of Health stating that that blood level is ”generally considered adequate for bone and overall health in healthy individuals”⁶.

The researchers found that women with vitamin D blood levels less than 50 nanomoles/liter compared with those with higher levels experienced increases in CES-D scores of 2.1 and 2.2 points higher at, respectively, 3- and 6-year follow-up. Overall, women with low vitamin D levels had double the risk of developing a depressive mood over the follow-up.

When looking at the men’s results, those with the vitamin D levels less than 50 nmol/L compared with those with higher levels experienced increases in CES-D scores of 1.9 and 1.1 points higher at 3- and 6-year follow-up. Men with low vitamin D levels also had a 60% higher risk of developing a depressive mood. These results have confirmed earlier research¹¹ showing that vitamin D levels in patients with major depressive disorder and those with minor depression were 14% lower than those of non-depressed participants.

For the researchers, “Our findings suggest that [having low vitamin D blood levels] is a risk factor for the development of depressive symptoms in older persons.” While the researchers didn’t make any recommendations on vitamin D intake needed to achieve 50 nmol/L, previous research has shown 15–25 micrograms (600 – 1000 IU) per day of vitamin D can produce blood levels of 75–112 nmol/L^{15, 16, 17}.

Greg Arnold is a Chiropractic Physician practicing in Danville, CA. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com

Reference:

1. Park E. The etiology of rickets. Physiol Rev 1923;3:106–119.

2. Giovanucci E. 25-Hydroxyvitamin D and Risk of Myocardial Infarction in Men: A Prospective Study. Arch Intern Med. 2008;168(11):1174-1180

3. Bao BY. Protective role of 1, alpha-25-dihydroxyvitamin D3 against oxidative stress in nonmalignant human prostate epithelial cells. International Journal of Cancer 2008; 122(12): 2699-2706

4. Evatt ML. Prevalence of Vitamin D Insufficiency in Patients With Parkinson Disease and Alzheimer Disease.Arch Neurol. 2008;65(10):1348-1352

5. Wagner CL. Does Vitamin D Make the World Go ‘Round’? Breastfeeding Medicine. December 2008, 3(4): 239-250

6. “Vitamin D” posted on the office of dietary supplements http://ods.od.nih.gov/factsheets/vitamind.asp

7. Wagner CL. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Pediatrics 2008;122:1142–1152

8. The World Health Organization. The World Health Report 2004: Changing History, Annex Table 3: Burden of disease in DALYs by cause, sex, and mortality stratum in WHO regions, estimates for 2002. Geneva: WHO, 2004.

9. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelvemonth DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.

10. Greenberg, P.E., et al., The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry, 2003. 64(12): p. 1465-75

11. Milaneschi Y. Serum 25-Hydroxyvitamin D and Depressive Symptoms in Older Women and Men. J Clin Endocrin Metab. First published ahead of print May 5, 2010 as doi:10.1210/jc.2010-0347

12. Welcome to the Center for Epidemiologic Studies Depression Scale (CES-D), A Screening Test for Depression - http://counsellingresource.com/quizzes/cesd/index.html

13. Beekman AT. Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a communitybased sample of older subjects in The Netherlands. Psychol Med 1997; 27:231–235

14. Hoogendijk WJ. Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry 2008; 65:508 –512

15. Vieth R. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J. 2004;3:8

16. Chapuy MC. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med. 1992;327:1637–42

17. Dawson-Hughes B. Serum 25-hydroxyvitamin D and functional outcomes in the elderly. Am J Clin Nutr. 2008;88:S537–40

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