Research report
Association between serum 25-hydroxyvitamin D and psychological health in older Chinese men in a cohort study

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Abstract

Background

Few studies evaluated the association between vitamin D and psychological health in Chinese. This study examined these associations in Chinese older men in Hong Kong.

Methods

Baseline serum 25-hydroxyvitamin D (25OHD), depression and cognitive function were assessed in 939 community-dwelling Chinese men aged > 65. Data on depression status at 4-year follow up was available in 629 men. Data were collected for confounding factors: demographics, number of diseases, smoking, alcohol use, body mass index, physical activity, mobility limitations, dietary intake, season of blood measurement, and serum parathyroid hormone level. Multivariate logistic regression analyses were performed with adjustments for confounding factors.

Results

An inverse association between serum 25OHD and baseline depression was observed. Men in the highest (> = 92 nmol/L) compared with lowest (< = 63 nmol/L) quartile of serum 25OHD had an adjusted odds ratio for depression of 0.46 (95% CI: 0.22-0.98, Ptrend = 0.004). The association was more pronounced in low vitamin D season than in high vitamin D season. No association was observed between serum 25OHD and incident depression at 4 years. Baseline cognitive impairment was not associated with serum 25OHD in all models.

Limitations

Self-reported measure of depression and cognitive performance, the small number of incident depression at 4-year follow up and selection bias may affect the study validity.

Conclusions

Serum 25OHD was inversely associated with depression at baseline and was not linked to baseline cognitive impairment and 4-year incident depression in Chinese older men. Future studies are warranted to evaluate these associations in populations with higher prevalence of vitamin D deficiency.

Introduction

Psychological health is an important dimension to healthy ageing, in addition to physical health. Conditions of particular concern are cognitive impairment/dementia, and depression, the prevalence of which increases with age (Gurland and Fogel, 1992, Jarvik et al., 1992). In recent years, there has been a growing interest in the association between blood 25-hydroxyvitamin D (25OHD) and cognitive impairment, and also between blood 25OHD and depression. Most studies have evaluated these associations in Caucasian populations (Annweiler et al., 2010, Hoogendijk et al., 2008, Llewellyn et al., 2010, Milaneschi et al., 2010) whose lifestyle differs from those of Chinese.

To our knowledge, only one study has examined the association between 25OHD and depressive symptoms in Chinese (Pan et al., 2009). In this population based cross sectional study, 3262 community residents aged 50–70 living in Beijing and Shanghai were included and depressive symptoms were defined as a Center for Epidemiological Studies of Depression Scale (CES-D) score of 16 or higher. The study showed no association between serum 25OHD and depressive symptoms. Regarding cognitive impairment, no study has been done to examine its association with serum 25OHD in Chinese.

The objective of this study was to examine the association between serum 25OHD and psychological health in Chinese older men living in Hong Kong at baseline and at the 4-year follow up.

Section snippets

Study population

The results of this paper were generated from part of the Os study in Hong Kong. The Os study was the first cohort study to examine the lifestyle and age-related diseases in Chinese elderly in Hong Kong. Two thousand Chinese community-dwelling men aged 65 years or over were recruited in a health survey between 2001 and 2003 through talks and recruitment notices in community centers for the older people and housing estates. The inclusion criteria were that all participants should be able to walk

Results

There were no significant differences in education level, smoking status, alcohol use, number of chronic diseases, number of ADLs, and DQI between men with (n = 988) and without (n = 1 012) blood measurement. Men with blood measurement were older, more likely to exercise, had lower BMI, less depressed as defined by GDS, and more likely to have cognitive impairment as defined by CSI-D (p < 0.05) (data not shown). The characteristic of subjects with and without depression, and with and without

Discussion

This study found an inverse association between serum 25OHD and depression, but no association between serum 25OHD and cognitive impairment or incident depression. The association between serum 25OHD and depression was also more pronounced in low vitamin D season as compared to high vitamin D season. There has been evidence from animal and human studies to suggest the important role of vitamin D in brain development and brain functions (Garcion et al., 2002, McCann and Ames, 2008). These

Role of funding source

Authors state that the study sponsor(s) had no involvement in design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Conflict of Interest

The authors declared no conflict of interests.

Acknowledgements

We wish to thank all subjects for their participation. The present study was supported by grants from the Research Grants Council of Hong Kong, CUHK 4101/02M; the Hong Kong Jockey Club Charities Trust; the SH Ho Centre for Gerontology and Geriatric and the Centre for Nutritional Studies, The Chinese University of Hong Kong.

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