Deficient or Insufficient Vitamin D Levels Associated with Depressive Symptoms in Older Adults

by | Jun 16, 2022 | 2022, Brain Health, Depression, Vitamin D - Mental Health

Written by Taylor Woosley, Staff Writer. Results of the study show that deficient and insufficient levels of serum 25-OH-D are associated with higher depression scores. The odds of a higher depression score were significantly higher in participants with insufficient 25-(OH)-D than in participants with 25-OH-D sufficiency (OR = 6.40, p < 0.001). 

Major depressive disorder (MDD) is a neuropsychological disorder characterized by a variety of symptoms that negatively affect the well-being and productivity of inflicted individuals, including cognitive impairment, emotional function, memory, motivation, and possible suicidal ideation 1. Depression is often triggered by stressful life events or trauma and is among the leading causes of disability globally 2. The World Health Organization predicts that by 2030, MDD will be the disease with the largest burden of disease in the world 3. MRI studies have reported cortical thinning and abnormal volumes in the hippocampus and amygdala in those suffering from MDD, along with fewer glial cells in the amygdala 4.

Vitamin D is fat-soluble vitamin crucial to bone health for its ability to regulate calcium and phosphate homeostasis and is important in the regulation of the adaptive immunity response 5. Vitamin D deficiency is an increasing common occurrence globally, with deficiency being defined as having plasma 25-hydroxyvitamin D (25(OH)D) levels of below 20 ng/mL 6. Increasing research has identified vitamin D as a neuroactive steroid that plays a critical role in the expression of neurotransmitters with its regulation, neuroimmunomodulation, and various neurotrophic factors 7. Low vitamin D levels have also been shown to impair mitochondrial function, resulting in elevated reactive oxygen species (ROS) and reduced ATP formation 8.

Albolushi et al. conducted a cross-sectional study to observe any potential associations between vitamin D status and depression occurrence. Participants (n=237, 54% female; 46% male) were included if they were Kuwait citizens aged 65 years or older, with no cognitive impairment or diagnosis of depression. Subject’s data, such as socioeconomic and demographic variables, education level, income, and lifestyle habits were obtained through questionnaires. The International Physical Activity Questionnaire for the Elderly (IPAQ) was used to measure physical activity levels. Vitamin D and calcium supplementation was collected using the Food Frequency Questionnaire (SFFQ) and The Fitzpatrick Classification of Skin Phototype was applied to measure the color of the participant’s skin. A sun exposure questionnaire was given to understand the subject’s attitude towards sun exposure.

Blood samples were taken to assess serum 25-(OH)-D concentrations, serum intact parathyroid hormone (PTH), and serum cortisol was measured early in the morning using electrochemiluminescence with e411/ELECSYS. Additionally, fasting blood glucose, serum calcium, and phosphorus (PO4) levels were measured. Subjects’ depressive symptoms were clinically evaluated and assessed using the 15-Item Geriatric Depression Scale (GDS-15) to specifically measure depressive symptoms in older populations. Participant’s vitamin D status were sufficient (36.7%), insufficient (32.9%), and deficient (30.4%).

Significant findings of the study are as follows:

  • When observing associations between GDS-15 scores and 25-(OH)-D levels, the mean 25(OH)D values for subjects in the normal, mild, moderate, and severe categories were 100 ±7, 71.2 ± 38.6, 58.6 ± 30.1 and 49.0 ± 6.93, respectively (p < 0.001).
  • The mean PO4 values for subjects with severe (1.43 ±29) depression were higher than those for participants with no (1.13 ± 0.13), mild (1.12 ± 0.17), and moderate (1.12 ± 0.16) depressive symptoms. The mean PTH values in participants with severe (15.4 ± 18.6) depression were also higher than those in participants with normal (5.55 ± 2.17), mild (5.89 ± 2.45), and moderate (6.19 ± 3.23) depression.
  • When observing associations between symptoms of depression and 25-(OH)-D levels, Welch’s test was statistically significant (Fwelch (3, 15.12) = 20.18, p < 0.001, indicating an association between the GDS-15 scores and 25(OH)D levels.
  • Ordinal Logistic Regression (OLR) Analysis was used for the association between depressive symptoms and 25-(OH)-D status. The odds of a higher depression score were significantly higher in participants with insufficient 25-(OH)-D than in participants with sufficient 25-(OH)-D (OR = 6.40, p < 0.001). The odds were even lower in participants with sufficient 25-(OH)-D (OR = 19.70, p < 0.001). Furthermore, gender displayed a statistically significant association with depression (OR = 0.34, p=0.01).
  • Physical activity was associated with lower odds of having a high depression score (OR = 0.34, p=0.001), indicating that the odds of having a high depression score was 66% lower in subjects who engaged in physical activity compared to those who did not.

Study findings show a significant association between serum 25-OH-D levels and symptoms of depression measured using the GDS-15. Subjects with higher levels of vitamin D, along with adequate physical activity levels, experienced a decreased occurrence of depressive symptoms. Limitations of the study include the inability to draw conclusions from the data due to the cross-sectional design of the study, the self-reporting nature of experiencing depression instead of having a clinical diagnosis, and the lack of measuring kidney function which could significantly affect vitamin D status.

Source: Albolushi, Thurayya, Manal Bouhaimed, and Jeremey Spencer. “Lower Blood Vitamin D Levels Are Associated with Depressive Symptoms in a Population of Older Adults in Kuwait: A Cross-Sectional Study.” Nutrients 14, no. 8 (2022): 1548.

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

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Posted June 16, 2022.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Lee MT, Peng WH, Kan HW, Wu CC, Wang DW, Ho YC. Neurobiology of Depression: Chronic Stress Alters the Glutamatergic System in the Brain-Focusing on AMPA Receptor. Biomedicines. Apr 27 2022;10(5)doi:10.3390/biomedicines10051005
  2. Zhukovsky P, Wainberg M, Milic M, et al. Multiscale neural signatures of major depressive, anxiety, and stress-related disorders. Proc Natl Acad Sci U S A. Jun 7 2022;119(23):e2204433119. doi:10.1073/pnas.2204433119
  3. Wang Y, Wei J, Chen T, et al. A Whole Transcriptome Analysis in Peripheral Blood Suggests That Energy Metabolism and Inflammation Are Involved in Major Depressive Disorder. Front Psychiatry. 2022;13:907034. doi:10.3389/fpsyt.2022.907034
  4. Peterson BS, Kaur T, Baez MA, et al. Morphological Biomarkers in the Amygdala and Hippocampus of Children and Adults at High Familial Risk for Depression. Diagnostics (Basel). May 12 2022;12(5)doi:10.3390/diagnostics12051218
  5. Lin LY, Mulick A, Mathur R, Smeeth L, Warren-Gash C, Langan SM. The association between vitamin D status and COVID-19 in England: A cohort study using UK Biobank. PLoS One. 2022;17(6):e0269064. doi:10.1371/journal.pone.0269064
  6. Trott M, Driscoll R, Iraldo E, Pardhan S. Associations between vitamin D status and sight threatening and non-sight threatening diabetic retinopathy: a systematic review and meta-analysis. J Diabetes Metab Disord. Jun 2022;21(1):1177-1184. doi:10.1007/s40200-022-01059-3
  7. Saji Parel N, Krishna PV, Gupta A, et al. Depression and Vitamin D: A Peculiar Relationship. Cureus. Apr 2022;14(4):e24363. doi:10.7759/cureus.24363
  8. Thurfah JN, Christine, Bagaskhara PP, Alfian SD, Puspitasari IM. Dietary Supplementations and Depression. J Multidiscip Healthc. 2022;15:1121-1141. doi:10.2147/jmdh.S360029