Serum 25-hydroxyvitamin D and self-reported mental health status in adult Danes

Vitamin D and depression in older adults: lessons learned from observational and clinical studies

Depression is a mental disorder triggered by the interaction of social, psychological and biological factors that have an important impact on an individual's life. Despite being a well-studied disease with several established forms of treatment, its prevalence is increasing, especially among older adults. New forms of treatment and prevention are encouraged, and some researchers have been discussing the effects of vitamin D (VitD) on depression; however, the exact mechanism by which VitD exerts its effects is not yet conclusive. In this study, we aimed to discuss the possible mechanisms underlying the association between VitD and depression in older adults. Therefore, we conducted a systematic search of databases for indexed articles published until 30 April 2021. The primary focus was on both observational studies documenting the association between VitD and depression/depressive symptoms, and clinical trials documenting the effects of VitD supplementation on depression/depressive symptoms, especially in older adults. Based on pre-clinical, clinical and observational studies, it is suggested that the maintenance of adequate VitD concentrations is an important issue, especially in older adults, which are a risk population for both VitD deficiency and depression. Nevertheless, it is necessary to carry out more studies using longitudinal approaches in low- and middle-income countries to develop a strong source of evidence to formulate guidelines and interventions.

Vitamin D and the athlete-patient: state of the art

Vitamin D deficiency is common in athletes. The conventional measurement of vitamin D levels provides a general indicator of body stores. However, there are nuances in its interpretation as values of 25(OH)D do not correlate absolutely with the amount of 'bioavailable' vitamin to the cells. Vitamin D should be regarded as a hormone and influences between 5% and 10% of our total genome. Determining the precise effect of the vitamin, isolated from the actions of other cofactors, is not straightforward and restricts our complete understanding of all of its actions. Deficiency has harmful effects on not only bone and muscle but also wider areas, including immunity and respiratory and neurological activities. More caution should be applied regarding the ability of supranormal vitamin D levels to elevate athletic performance. Hopefully, future research will shed more light on optimal levels of vitamin D and supplementation regimes, and improved understanding of its intracellular control of our genetic mechanisms and how extrinsic influences modify its activity.

Effects of vitamin D on mood and sleep in the healthy population: Interpretations from the serotonergic pathway

Vitamin D insufficiency is common in the healthy population. Recent insights addressed the role of vitamin D in serotonin and melatonin regulation, suggesting that increasing vitamin D status may be helpful for improving mood and sleep. This literature review covers the current state of evidence regarding potential effects of vitamin D on mood and sleep indicators in healthy people. In total, 11 observational studies were found for sleep, and 54 studies on mood (including ten RCTs). These studies revealed mixed results for both sleep and mood. The findings were interpreted based on the previously proposed serotonergic pathway of vitamin D. Implications and challenges for future research regarding the timing of blood sampling, timing and dosage of supplement intake and investigating the response dynamics are discussed.

Serum 25-Hydroxyvitamin D Concentrations Are Associated with Mental Health and Psychosocial Stress in Young Adults

We aimed to test the hypothesis that serum 25-hydroxyvitamin D₃ (25(OH)D) concentration is associated with mental health and life stress measures in young adults and investigate gender and racial disparities in these associations. This study comprised 327 black and white participants. Depression, trait anxiety, perceived stress, and hostility were measured by the following validated instruments: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and Cook–Medley Hostility Scale (CMHS). Linear regression was used to estimate correlations between serum 25(OH)D concentration and mental health measurements in the total population and in subgroups stratified by gender and race. In this sample (28.2 ± 3.1 years, 52% female, 53% black), serum 25(OH)D concentration was negatively related to BDI, STAI, PSS, total CMHS score, and the majority of CMHS subscale scores (p-values < 0.05). Stratified by gender, most of these associations remained significant only in women (p-values < 0.05). Stratified by race, higher 25(OH)D concentrations in white participants were significantly related to lower BDI, STAI, PSS, and CMHS-cynicism subscales (p-values < 0.05); 25(OH)D concentrations in the black participants were only inversely associated with CMHS and most CMHS subscales (p-values < 0.05) but not with BDI, STAI, and PSS. We present novel findings of consistent inverse relationships between serum 25(OH)D concentration and various measures of mental health and life stress. Long-term interventional studies are warranted in order to investigate the roles of vitamin D supplementation in the prevention and mitigation of depression, anxiety, and psychological stress in young adults.

Quality of life and psychological functioning in postmenopausal women undergoing aromatase inhibitor treatment for early breast cancer

INTRODUCTION

Aromatase inhibitors (AIs) dramatically increased breast cancer (BC) survival, leading to enhanced attention to their long-term consequences on psychological functioning. Conflicting data has been examined regarding the association between AIs administration and the clinical psychological features in BC survivors (BCSs).

PURPOSE

As psychological symptoms often occur in such chronic diseases, our study aimed at exploring anxious and depressive symptoms and the perceived quality of life (QoL) in BCSs assessed for osteoporosis.

METHODS

The total sample consisted of a clinical sample of 51 outpatient postmenopausal women, diagnosed with BC, and a control group composed of 51 healthy postmenopausal women. All recruited participants were evaluated through the clinical gold standard interview and completed the following self-rating scales: the Hamilton Anxiety Rating Scale, Beck Depression Inventory II edition, and 36-Item Short Form Health Survey, which were administered at baseline and after 6 months in BCSs in AIs treatment, compared with controls. Moreover, all participants were assessed for vitamin D status, bone mineral density (BMD) and subclinical vertebral fractures. Data regarding age, age at menopause, body mass index (BMI), smoking habits and alcohol consumption was collected.

RESULTS

BCSs (n = 51) showed higher anxious and depressive symptoms, and lower perceived QoL vs. controls (n = 51) (p<0.05 for all). After 6 months of treatment with AIs, BCSs showed significant reduction of anxious and depressive symptoms and a significantly higher perceived QoL for both physical and mental components, vs. controls.

CONCLUSIONS

The improvement of clinical psychological features and perceived QoL was associated with AIs treatment in women being treated with, for early breast cancer. Further studies are needed to obtain a deeper comprehension of the correlation between clinical psychological and physical features in BCSs.

Vitamin D status was not associated with anxiety, depression, or health-related quality of life in Middle Eastern and African-born immigrants in Sweden

Active vitamin D is a neurosteroid that may modulate brain function. Associations between vitamin D deficiency and depression and anxiety have been demonstrated. We hypothesized that there was an association between anxiety, depression, and health-related quality of life (HRQOL) and vitamin D status. To test this hypothesis, we examined the association between anxiety, depression, and HRQOL and 25-hydroxyvitamin D (25[OH]D) concentrations in the Middle Eastern and African-born immigrant population. All immigrants aged 25-65 years, born in 9 African or Middle Eastern countries, and living in 3 districts in Umeå (n = 1306) were invited, with 195 English- or Swedish-speaking immigrants (104 men and 91 women) participated. Anxiety and depression were measured using the Hospital Anxiety and Depression scale. HRQOL was measured using EuroQoL-5 Dimension 3 Level Questionnaire and EuroQoL Visual Analogue Scale. Serum 25(OH)D was measured using liquid chromatography-tandem mass spectrometry. Associations were determined using logistic and linear regression. Analyses were adjusted for sex, age, origin, socioeconomic factors, lifestyle, chronic diseases, and obesity. In total, 71% had 25(OH)D less than 50 nmol/L and 11% had 25(OH)D less than 25 nmol/L. Anxiety, depression, and HRQOL were not associated with 25(OH)D in the immigrant population. Anxiety was common in female immigrants from the Middle East (32.7%); and after adjustment, lower 25(OH)D concentrations were associated with higher risk of anxiety (25[OH]D ≤ 49 nmol/L vs 25[OH]D ≥ 50 nmol/L: odds ratio 23.2 [95% confidence interval 1.97 - 271.9] P = .012) in this subgroup only; however, reverse causality could not be excluded. In conclusion, the study showed no association between depression, anxiety, or HRQOL and vitamin D status in the immigrant population.

Change in serum 25-hydroxyvitamin D and parallel change in depressive symptoms in Dutch older adults

OBJECTIVES

Previous prospective studies on the association between vitamin D status and depression used a single 25-hydroxyvitamin D (25(OH)D) measurement. We investigated the association between change in serum 25(OH)D and parallel change in depressive symptoms over time in Dutch older adults.

DESIGN

A population-based, prospective study in two cohorts of older men and women from the Longitudinal Aging Study Amsterdam.

METHODS

Serum 25(OH)D concentrations were determined at two time points: in 1995/1996 and 13 years later in the older cohort (aged 65–88y, n = 173) and in 2002/2003 and 6 years later in the younger cohort (55–65 years, n = 450). At these time points, depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale (CES-D). Associations were tested by multiple linear regression analyses.

RESULTS

During follow-up, serum 25(OH)D concentrations increased in 32.4% of the older cohort and in 69.8% of the younger cohort. In the older cohort, change in 25(OH)D was not associated with change in CES-D score. In the younger cohort, no associations were observed in participants with higher baseline 25(OH)D concentrations (>58.6 nmol/L), but in those with lower baseline 25(OH)D concentrations, an increase in 25(OH)D was associated with a decrease in CES-D score (adjusted B per 10 nmol/L 25(OH)D increase: −0.62 (95% CI: −1.17, −0.07)).

The prevalence of depressive symptoms in Chinese longevous persons and its correlation with vitamin D status

Background

Hypovitaminosis D and depressive syndromes are common conditions in old adults. However, little is known about the relationship between vitamin D and depression in exceptional aged people. The objective of this study is to evaluate the relationship between vitamin D levels and depressive symptoms in Chinese longevous persons.

Methods

We used a dataset from a cross-sectional survey of a sample of Chinese longevous people with self-reported age 100 or older, including 175 men and 765 women, was conducted from June 2014 to December 2016 in Hainan Province, China. Data on demographics, lifestyle characteristics and health conditions were collected using a structured questionnaire. Anthropometrics and blood samples were obtained following the standard procedure. Depressive symptoms of the participants were assessed using a shortened version of the Geriatric Depression Scale (GDS-15). Serum vitamin D levels were measured using an automated radioimmunoassay.

Results

The prevalence of longevous persons with depressive symptoms among the sample was 32.2% (95% confidence interval: 29.7–34.7%). Serum vitamin D levels were lower in participants with depressive symptoms than in those without (20.8 ± 8.7 vs. 23.7 ± 9.7, ng/mL). Vitamin D deficiency was an independent risk factor for depression after controlling for the potential covariates (Odds ratio = 1.47, 95% Confidence interval = 1.08–2.00; p = 0.014). A negative relationship between serum vitamin D levels and depressive symptoms was also detected, and the relationship remained significant after adjusting for a wide range of other covariates. The multivariate adjusted odds ratio of depressive symptoms for the lowest versus highest quartiles of vitamin D levels was 1.73 (95% confidence interval: 1.10–2.72), and the adjusted odds ratio with a 5 ng/mL decrement of serum 25OHD levels was 1.10 (95% confidence interval: 1.01–1.19).

Conclusions

This study showed an inverse association between vitamin D levels and depressive symptoms among Chinese longevous persons. Depressive symptoms should be screened in longevous persons who had vitamin D deficiency. Further studies on vitamin D supplement and prevention along with treatment of depression are needed among very old population.

VITAMIN D STATUS IN PATIENTS WITH MENTAL DISORDERS: A CROSS-SECTIONAL ANALYSIS OF SINGLE COHORT FROM ROUTINE PRACTICE

Context

Clinical research suggests that vitamin D deficiency correlates with mental illnesses.

Objective

The aim was to prove that the patients from the psychiatric health care service in Serbia had higher vitamin D deficiency than patients from general practice.

Design

The study had a cross-sectional design.

Methods

The study included 47 patients aged 19 - 76 of both sexes with different mental disorders. We performed sample size calculation on available data for vitamin D deficiency in patients in health care facilities compared with the general population. The concentrations of vitamin D in serums were measured by HPLC (high performance/pressure liquid chromatography).

Results

The mean value of vitamin D (standard deviation) in the whole group of study subjects was 16.27(10.62) ng/mL; 68.1% of the patients had a deficiency of vitamin D (25(OH)D<20 ng/mL). The difference is statistically significant from expected proportion of people with vitamin D deficiency in general practice (p=0.040). Serum concentrations of 25(OH)D were significantly correlated with serum concentrations of phosphorus (ϱ=0.336, p=0.024) and sodium (ϱ=0.304, p=0.038).

Conclusions

The patients of psychiatry health care had significantly higher frequency of vitamin D deficiency than expected. There is a significant association between serum levels of vitamin D, and phosphate and sodium.