title: Physiological Levels of Melatonin Relate to Cognitive Function and Depressive Symptoms: The HEIJO-KYO Cohort.
abstract: BACKGROUND
  In contrast with randomized controlled trials, observational studies have suggested that physiological levels of melatonin are reduced in patients with dementia or depression, but the relationship has not been evaluated in large populations.
  
  
  OBJECTIVE
  The objective was to determine the relationships between physiological levels of melatonin and cognitive function and depressive symptoms.
  
  
  METHODS
  A cohort of 1105 community-dwelling elderly individuals was enrolled in this cross-sectional study (mean age, 71.8 ± 7.1 y).
  
  
  METHODS
  Urinary 6-sulfatoxymelatonin excretion (UME) and Mini-Mental State Examination (MMSE; n = 935) and Geriatric Depression Scale (GDS; n = 1097) scores were measured as indices of physiological melatonin levels, cognitive function, and depressive symptoms, respectively.
  
  
  RESULTS
  With increases in UME quartiles, the prevalence of cognitive impairment (MMSE score ≤ 26) and depressed mood (GDS score ≥ 6) significantly decreased (P for trend = .003 and .012, respectively). In multivariate logistic regression models, after adjusting for confounders such as age, gender, socioeconomic status, physical activity, and sleep/wake cycles, higher UME levels were significantly associated with lower odds ratios (ORs) for cognitive impairment and depressed mood (ORs: Q1 = 1.00; Q2 = 0.88 and 0.76; Q3 = 0.66 and 0.85; Q4 = 0.67 and 0.53; P for trend = .023 and .033, respectively). In addition, the highest UME group showed a significantly lower OR for depressed mood than the lowest UME group (Q4 vs Q1: OR, 0.53; 95% confidence interval, 0.32-0.89; P = .033). UME levels above the median value were significantly associated with a lower OR for cognitive impairment, even after further adjustment for depressive symptoms (OR = 0.74; 95% confidence interval, 0.55-0.99; P = .043).
  
  
  CONCLUSIONS
  Significant associations of higher physiological melatonin levels with lower prevalence of cognitive impairment and depressed mood were revealed in a large general elderly population. The association between physiological melatonin levels and cognitive function was independent of depressive symptoms.
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Obayashi
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Saeki
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Iwamoto
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tone
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kataoka
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Morikawa
authors.affiliation: Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000503:physiopathology / Q000523:psychology* / Q000652:urine*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008550:Melatonin / Q000031:analogs & derivatives* / Q000652:urine; D008875:Middle Aged; D009483:Neuropsychological Tests; D012111:Residence Characteristics
chemical_list: C054513:6-sulfatoxymelatonin; D008550:Melatonin