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Frailty 2X less likely in depressed seniors having a good level of vitamin D – Nov 2018

Vitamin D deficiency and course of frailty in a depressed older population.

Aging Ment Health. 2018 Nov 15:1-7. doi: 10.1080/13607863.2018.1515885.

van den Berg KS1,2, Arts MHL2,3, Collard RM4, van den Brink RHS2, Comijs HC5, Marijnissen RM2,6, Oude Voshaar RC2.
1 Department of Psychiatry , St. Antonius Hospital , Nieuwegein , The Netherlands.
2 University Centre of Psychiatry, University Medical Centre Groningen , University of Groningen , Groningen , The Netherlands.
3 Dept of Geriatric Psychiatry and Neuropsychiatry , Mental Health Care-West Northern Brabant (GGZ-WNB) , Bergen op Zoom , the Netherlands.
4 Department of Psychiatry , Radboud University Medical Center , Nijmegen , The Netherlands.
5 Department of Psychiatry, VU Medical Centre/GGZinGeest , Amsterdam Public Health Research Institute , Amsterdam , The Netherlands.
6 Department of Old Age Psychiatry , Pro Persona , Renkum , The Netherlands.

OBJECTIVE: To study the association between vitamin D levels and frailty, its components and course in a depressed sample.

METHODS:
Baseline and two-year follow-up data from the depressed sample of the Netherlands Study of Depression in Older persons (NESDO), a prospective observational cohort study, were analyzed. The 378 participants (aged 60-93) had a diagnosis of depression according to DSM-IV criteria. Frailty was defined according to Fried's physical phenotype. 25-OH vitamin D measurement was performed by liquid chromatography - tandem mass spectrometry. Linear and logistic regression analyses were performed, adjusted for covariates.

RESULTS:
Higher vitamin D levels were cross-sectionally associated with lower prevalence of frailty (OR 0.64 [95%-CI 0.45 - 0.90], p = .010), predicted a lower incidence of frailty among non-frail depressed patients (OR 0.51 [95%-CI 0.26 - 1.00], p=.050), and, surprisingly, the persistence of frailty among frail depressed patients (OR 2.82 [95%-CI 1.23 - 6.49], p=.015).

CONCLUSIONS:
In a depressed population, higher vitamin D levels were associated with lower prevalence and incidence of frailty. Future studies should examine whether the favorable effect of low vitamin D levels on the course of frailty can be explained by confounding or whether unknown pathophysiological mechanisms may exert protective effects.

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