Effect of vitamin D supplementation on depression in older Australian adults. (3rd December 2022)

• Record Type: Journal Article
• Authors: Rahman, Sabbir T.; Waterhouse, Mary; Romero, Briony Duarte; Baxter, Catherine; English, Dallas R.; Almeida, Osvaldo P.; Berk, Michael; Ebeling, Peter R.; Armstrong, Bruce K.; McLeod, Donald S. A.; Hartel, Gunter; O'Connell, Rachel L.; Pham, Hai; Scott, James G.; van der Pols, Jolieke C.; Venn, Alison J.; Webb, Penelope M.; Whiteman, David C.; Neale, Rachel E.
• Is Part Of: International journal of geriatric psychiatry. Volume 38:Number 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-12-03
• Subjects: antidepressants -- depression -- mental disorders -- PHQ‐9 -- prevention -- randomized controlled trial -- vitamin D supplementation; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5847
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract: Objectives: To investigate whether vitamin D supplementation reduces depressive symptoms and incidence of antidepressant use. Methods: We used data from the D‐Health Trial ( N = 21, 315), a randomized double‐blind placebo‐controlled trial of monthly vitamin D3 for the prevention of all‐cause mortality. Participants were Australians aged 60–84 years. Participants completed the Patient Health Questionnaire (PHQ–9) at 1, 2 and 5 years after randomization to measure depressive symptoms; national prescribing records were used to capture antidepressant use. We used mixed models and survival models. Results: Analyses of PHQ‐9 scores included 20, 487 participants (mean age 69·3 years, 46% women); the mean difference (MD) in PHQ‐9 score (vitamin D vs. placebo) was 0·02 (95% CI −0·06, 0·11). There was negligible difference in the prevalence of clinically relevant depression (PHQ‐9 score ≥10) (odds ratio 0·99; 95% CI 0·90, 1·08). We included 16, 670 participants in the analyses of incident antidepressant use (mean age 69·4 years, 43% women). Incidence of antidepressant use was similar between the groups (hazard ratio [HR] 1·04; 95% CI 0·96, 1·12). In subgroup analyses, vitamin D improved PHQ‐9 scores in those taking antidepressants at baseline (MD −0·25; 95% CI −0·49, −0·01; p‐interaction = 0·02). It decreased risk of antidepressant use in participants with predicted 25(OH)D concentration <50 nmol/L (HR 0·88; 95% CI 0·75, 1·02; p‐interaction = 0·01) and increased risk in those with predicted 25(OH) D ≥ 50 nmol/L (HR 1·10; 95% CI 1·01, 1·20). Conclusion: Monthly supplementation with high‐dose vitamin D3 was not of benefit for measures of depression overall, but there was some evidence of benefit in subgroup analyses. Clinical Trial Registration: The trial is registered on the Australian New Zealand Clinical Trials Registry: ACTRN12613000743763. https://www.anzctr.org.au/ . Key points: Lower serum 25‐hydroxyvitamin D concentration are associated with increased risk of depression in observational studies; however, there is limited evidence from large, long‐term trials. In this population‐based randomized placebo‐controlled trial involving 21, 315 participants aged ≥60 years, vitamin D3 supplementation did not improve overall mood and or reduce the incidence of antidepressant use over a 5‐year follow‐up period. There was some suggestion of a beneficial effect in people taking antidepressants at baseline and in those with lowpredicted 25‐hydroxyvitamin D concentration.