title: Effect of long-term supplementation with folic acid and B vitamins on risk of depression in older women.
abstract: BACKGROUND
  Homocysteine-lowering nutrients may have preventive/ameliorative roles in depression.
  
  
  OBJECTIVE
  To test whether long-term B-vitamin/folate supplementation reduces depression risk.
  
  
  METHODS
  Participants were 4331 women (mean age 63.6 years), without prior depression, from the Women's Antioxidant and Folic Acid Cardiovascular Study - a randomised controlled trial of cardiovascular disease prevention among 5442 women. Participants were randomly assigned to receive a combination of folic acid (2.5 mg/d), vitamin B6 (50 mg/d) and vitamin B12 (1 mg/d) or a matching placebo. Average treatment duration was 7 years. The outcome was incident depression, defined as self-reported physician/clinician-diagnosed depression or clinically significant depressive symptoms.
  
  
  RESULTS
  There were 524 incident cases. There was no difference between active v. placebo groups in depression risk (adjusted relative risk 1.02, 95% CI 0.86-1.21, P = 0.81), despite significant homocysteine level reduction.
  
  
  CONCLUSIONS
  Long-term, high-dose, daily supplementation with folic acid and vitamins B6 and B12 did not reduce overall depression risk in mid-life and older women.
authors.affiliation: Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Olivia I
authors.initials: OI
authors.lastname: Okereke
authors.affiliation: Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Cook
authors.affiliation: Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
authors.affiliation: Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Van Denburgh
authors.affiliation: Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.affiliation: Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
mesh_terms: D000368:Aged; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy*; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D057566:Self Report; D014805:Vitamin B 12 / Q000627:therapeutic use*; D025101:Vitamin B 6 / Q000627:therapeutic use*
chemical_list: D025101:Vitamin B 6; D005492:Folic Acid; D014805:Vitamin B 12