Kognitif Sağlıklı Yaşlılarda D Vitamini Depresyon ile İlişkili Olabilir mi?

Year 2022, , 1 - 7, 30.04.2022

Açelya Gökdeniz Yıldırım , Fatma Sena Dost

https://doi.org/10.47141/geriatrik.1086895

Abstract

Amaç: Depresyon, yaşlılarda morbidite ve mortaliteye sebep olan geriatrik sendromlardan biridir. Depresyonun erken tanı ve tedavisi bireyin yaşam kalitesi için önemlidir. D vitamini depresyon patofizyolojisinde rol oynayan bir nörosteroid hormondur ve eksikliği yaşlılarda sık görülmektedir. Bu çalışmanın amacı, yaşlılarda sık görülen geriatrik sendromlardan biri olan depresyonun D vitamini ile ilişkisini değerlendirmektir.

Gereç ve Yöntemler: Çalışmaya 60 yaş ve üzeri 392 hasta alındı. Çalışmamız kesitsel retrospektif olarak dizayn edildi. Katılımcıların sosyodemografik verileri, komorbiditeleri, laboratuvar parametreleri, geriatrik depresyon ölçeği puanları, yürüme ve denge ölçeklerini içeren Ayrıntılı Geriatrik Değerlendirme verileri hasta takip dosyalarından incelenerek değerlendirildi. Elde edilen sonuçlarla prevelans analizi yapıldı.

Bulgular: D vitamini değerleri, depresyon tanısı olan grupta, depresyon tanısı olmayan gruptan anlamlı olarak düşüktü (p<0,01). Her iki grup yaş açısından benzerlik göstermekteydi. Depresyon tanısı alanlarda kadın cinsiyet oranı daha fazlaydı (p<0,01). Depresyon; düşme, malnutrisyon, kadın cinsiyet, düşük eğitim durumu ve ilaç sayısı ile ilişkili bulundu (p<0,001). Yaş ve cinsiyet faktörü düzeltildiğinde, depresyonun D vitamini ile ilişkisi ortadan kalktı.

Sonuç: Depresyon ve D vitamini arasında anlamlı bir ilişki bulunmaktadır. Depresyonu olan yaşlı bireylerde D vitamini değerlerini normalize etmek, oluşabilecek morbidite ve mortaliteyi önlemek için yapılan müdahalelerden biri olabilir. Bu konuda yapılacak destekleyici çalışmalara ihtiyaç vardır. 

Keywords

D vitamini, geriatrik depresyon, geriatrik sendrom

Supporting Institution

yok

Project Number

3308-GOA

May Vitamin D Be Related to Depression in Cognitive Healthy Older Adults?

Abstract

Aim: Depression is one of the geriatric syndromes that cause morbidity and mortality in the elderly. Early diagnosis and treatment of depression are essential for the individual's quality of life. Vitamin D is a neurosteroid hormone that plays a role in the pathophysiology of depression, and its deficiency is common in the elderly. This study aims to evaluate the relationship between depression, one of the most common geriatric syndromes in the elderly, and vitamin D.

Material and Methods: 392 patients aged 60 years and older were included in the study. It was designed as a cross-sectional retrospective. Comprehensive Geriatric Assessment data, including participants' sociodemographic data, comorbidities, laboratory parameters, geriatric depression scale scores, and gait and balance scales, were evaluated by examining patient follow-up files. A prevalence analysis was performed with the results obtained.

Results: Vitamin D values were significantly lower in the group with depression than those without depression (p<0.01). There was no significant age difference between the two groups. The female gender ratio was higher in those diagnosed with depression. Depression was associated with falling, malnutrition, female gender, low educational status, and the number of medications (p<0.001). The relation between depression and vitamin D disappeared when age and gender were adjusted.

Conclusions: There is a significant relationship between depression and vitamin D. Normalizing vitamin D values in elderly individuals with depression may be one of the interventions to prevent possible morbidity and mortality. Further studies are needed to support these results.

Keywords

Vitamin D, geriatric depression, geriatric syndrome

Project Number

3308-GOA

References

• 1. Bunce D, Batterham PJ, Mackinnon AJ, et al. Depression, anxiety and cognition in community-dwelling adults aged 70 years and over. J Psychiatr Res. 2012; 46(12): 1662–1666.
• 2. Hammami S, Hajem S, Barhoumi A, et al. Screening for depression in an elderly population living at home. Interest of the mini-geriatric depression scale. Rev Epidemiol Sante Publique. 2012; 60(4): 287–293.
• 3. Sang WJ, Kim YK. Molecular neurobiology and promising new treatment in depression. Int J Mol Sci. 2016; 17: 381.
• 4. Eyles DW, Smith S, Kinobe R, et al. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat. 2005; 29: 21–30.
• 5. Geng C, Shaikh AS, Han W, et al. Vitamin D and depression: mechanisms, determination and application. Asia Pac J Clin Nutr. 2019; 28(4): 689-694.
• 6. Gallagher JC. Vitamin D and aging. Endocrinol Metab Clin N Am. 2013; 42(2): 319–332.
• 7. Briggs R, McCarroll K, O’Halloran A, et al. Vitamin D Deficiency Is Associated With an Increased Likelihood of Incident Depression in Community-Dwelling Older Adults. JAMDA. 2019; 20: 517-523.
• 8. Ramachandran V, Sarada Menon M, Arunagiri S. Socio-cultural factors in late onset depression. Indian J Psychiatry. 1982; 24: 268-273.
• 9. Barnard K, Colon-Emeric C. Extraskeletal effects of vitamin D in older adults: cardiovascular disease, mortality, mood, and cognition. Am J Geriatr Pharmacother 2010; 8: 4–33.
• 10. Mütevazı MB . Vitamin D, light and mental health. J Photochem Photobiol B. 2010; 101: 142–149.
• 11. Güngen C, Ertan T, Eker E, et al. Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population. Turk Psikiyatri Derg. 2002; 13(4): 273-281.
• 12. Durmaz B. Validity and Reliability of Geriatric Depression Scale - 15 (Short Form) in Turkish older adults, North. Clin. Istanbul. 2017; 5(3); 216–220.
• 13. Lawton M, Brody E. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3): 179-186.
• 14. Küçükdeveci AA, Yavuzer G, Tennant A, et al. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 2000 ;32(2): 87-92.
• 15. Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us?. J Nutr Health Aging. 2006; 10(6): 466-487.
• 16. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000; 80(9): 896-903.
• 17. Volkert J, Schulz H, Härter M, et al. The prevalence of mental disorders in older people in Western countries - a meta-analysis. Ageing Res. Rev. 2013; 12(1); 339–353.
• 18. Van Agtmaal MJM, Houben AJHM, PouwerF, et al. Association of microvascular dysfunction with late-life depression: A systematic review and metaanalysis. JAMA Psychiatry. 2017; 74(7); 729–739.
• 19. Mutlay F, Erken N, Dost Günay FS, et al. Yaşlılarda Depresyon Düşme Sıklığı ile İlişkilendirilebilir mi? Geriatrik Bilimler Dergisi / Journal of Geriatric Science. 2020; 3(3): 103-109.
• 20. Eyles DW, Smith S, Kinobe R, et al. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat. 2005; 29(1): 21-30.
• 21. Langub MC, Herman JP, Malluche HH, et al. Evidence of functional vitamin D receptors in rat hippocampus. Neuroscience. 2001; 104(1): 49-56.
• 22. Wilkins CH, Sheline YI, Roe CM, et al. Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry. 2006; 14(12): 1032-1040.
• 23. Gloth FM, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging. 1999;3(1): 5-7.
• 24. Spedding S. Review: vitamin D and Depression: a systematic review and metaanalysis comparing studies with and without biological flaw. Nutrients. 2014; 6: 1501–1518.
• 25. De Koning EJ, Elstgeest LEM, Comijs HC, et al. Vitamin D status and depressive symptoms in older adults: A role for physical functioning? Am J Geriatr Psychiatry. 2018; 26(11): 1131-1143.
• 26. Milaneschi Y, Shardell M, Corsi AMM, et al. Serum 25-hydroxyvitamin D and depressive symptoms in older women and men. J Clin Endocrinol Metab. 2010; 95(7): 3225-3233.
• 27. Alexopoulos GS. Depression in the elderly. Lancet. 2005; 365(9475): 1961-1970.
• 28. Sahin Alak ZY, Ates Bulut E, Dokuzlar O, et al. Long-term effects of vitamin D deficiency on gait and balance in the older adults. Clin Nutr. 2020 ; 39(12): 3756-3762.
• 29. Ates Bulut E, Soysal P, Yavuz I, et al. Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study. Am J Alzheimers Dis Other Demen. 2019; 34(2): 112-117.