title: Vitamin D and depression in geriatric primary care patients.
abstract: OBJECTIVE
  Vitamin D deficiency is common in the elderly. Vitamin D deficiency may affect the mood of people who are deficient. We investigated vitamin D status in older primary care patients and explored associations with depression.
  
  
  METHODS
  A cross-sectional study was conducted and association analyses were performed. Primary care patients at a single academic medical center who were ≥60 years with serum total 25-hydroxyvitamin D (25[OH]D) levels were included in the analysis. The primary outcome was a diagnosis of depression. Frailty scores and medical comorbidity burden scores were collected as predictors.
  
  
  RESULTS
  There were 1618 patients with a mean age of 73.8 years (±8.48). The majority (81%) had optimal (≥25 ng/mL) 25(OH)D range, but 17% met mild-moderate (10-24 ng/mL) and 3% met severe (<10 ng/mL) deficiencies. Those with severe deficiency were older (P < 0.001), more frail (P < 0.001), had higher medical comorbidity burden (P < 0.001), and more frequent depression (P = 0.013). The 694 (43%) with depression had a lower 25(OH)D than the nondepressed group (32.7 vs 35.0, P = 0.002). 25(OH)D was negatively correlated with age (r = -0.070, P = 0.005), frailty (r = -0.113, P < 0.001), and medical comorbidity burden (r = -0.101, P < 0.001). A 25(OH)D level was correlated with depression (odds ratio = 0.990 and 95% confidence interval [CI] = 0.983-0.998, P = 0.012). Those with severe vitamin D deficiency were twice as likely to have depression (odds ratio = 2.093 with 95% CI 1.092-4.011, P = 0.026).
  
  
  CONCLUSIONS
  Vitamin D deficiency was present in a fifth of this older primary care population. Lower vitamin D levels were associated with depression. Those with severe deficiency were older and more likely had depression.
authors.affiliation: Division of Outpatient Consultation, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA. lapid.maria@mayo.edu
authors.forename: Maria I
authors.initials: MI
authors.lastname: Lapid
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Cha
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D016330:Frail Elderly; D006801:Humans; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000150:complications*
keywords: elderly; frailty; hydroxyvitamin D; mood