Vitamin D concentration and its association with past, current and future depression in older men: The Health In Men Study.
BACKGROUND
Vitamin D deficiency has been associated with depression in later life, but it remains unclear whether this association is truly causal.


METHODS
Observational study examining the retrospective, cross-sectional and prospective associations between vitamin D concentration and depressed mood in a community-derived sample of 3105 older men living in metropolitan Perth, Western Australia. We measured the plasma concentration of 25-hydroxyvitamin D using standard procedures. Past depression was ascertained by direct questioning and through the use of administrative health data linkage. A geriatric depression scale score equal or greater 7/15 established the presence of current depression. Incident depression was established by a patient health questionnaire (PHQ-9) score ≥ 10 or by administrative health data linkage during the 6-year follow up (range 0.1-10.9 years).


RESULTS
Vitamin D concentration <50 nmol/L was associated with greater odds of current (OR=1.65, 95% CI=1.13, 2.42) but not past depression (OR=1.15, 95% CI=0.83, 1.58). Of the 2740 men with no past or current history of depression, 81 developed clinically significant symptoms during follow up. The adjusted hazard ratio of incident depression for men with plasma vitamin D <50 nmol/L was 1.03 (95% CI=0.59, 1.79; adjusted for age, living arrangements, season, and prevalent cardiovascular diseases).


CONCLUSIONS
Our results do not support a role for vitamin D in the causation of depression, although a small antidepressant effect of vitamin D cannot be entirely discarded. Large randomised placebo-controlled trials are required to dismiss or establish with certainty the causal link between vitamin D deficiency and depression.
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia; WA Centre for Health & Ageing, Centre for Medical Research, Perth, Australia; Department of Psychiatry, Royal Perth Hospital, Perth, Australia. Electronic address: osvaldo.almeida@uwa.edu.au.
Osvaldo P
OP
Almeida
School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Neurology, Sir Charles Gairdner Hospital, Perth, Australia.
Graeme J
GJ
Hankey
School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Endocrinology, Fremantle Hospital, Fremantle, Australia.
Bu B
BB
Yeap
Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Australia; Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia.
Jonathan
J
Golledge
WA Centre for Health & Ageing, Centre for Medical Research, Perth, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia.
Leon
L
Flicker
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D014815:Vitamins; D014904:Western Australia / Q000453:epidemiology
D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D
Ageing; Depression; Epidemiology; Mental health; Risk factors; Vitamin D