Mortality in older adults as an outcome of the association of depressive symptoms and 25(OH)D deficiency: an integrative review
DOI:
https://doi.org/10.33448/rsd-v12i5.41565Keywords:
Depressive symptoms; Vitamin D deficiency; Older adults; Mortality.Abstract
Depression is a disease that causes great disability and has a high prevalence among the older adults. Also of expressive distribution is the deficiency of vitamin D, which favors the development of depressive symptoms. Both depression and low vitamin D levels are predictors of higher mortality. This integrative review aimed to objective was to gather information about the combination of vitamin D deficiency and the presence of depression, and the influence on mortality in older adults. A search was carried out in the electronic databases BVS, Embase, Cochrane and PubMed, no restrictions on type of study, language or time, with the descriptors “depression”, “vitamin D deficiency”, “older adults”, “mortality”, and their variations. The initial search identified 302 articles. After excluding duplicates and papers that did not include all the descriptors of interest, two articles were included for this integrative review. It was identified that the studied population had low levels of 25(OH)D, and that this was associated with the occurrence of depressive symptoms. The joint analysis of depression and 25(OH)D deficiency, and the impact on mortality was performed in only one of the articles. In this study, depressed individuals with a higher risk of death had 25(OH)D deficiency. In conclusion, there was an association between depression and low levels of vitamin D, relating to higher mortality. These variables are modifiable, however, the literature presents little data in this context to allow decision making. Further research in the area may clarify the relationship between depression, vitamin D deficiency and mortality, and enable changes in the course of this outcome.
References
Astorga-Aliaga, A., Díaz-Arroyo, F., Carreazo, N. Y., Caballero, K. C., Rodríguez-Cuba, M. A., Runzer-Colmenares, F. & Parodi-García, J. (2022). Depression symptoms and mortality in elderly peruvian navy veterans: a retrospective cohort study. Advances in Gerontology, 12, 56–62. https://doi.org/10.1134/S2079057022010039
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., rev. ed.).
Anglin, R. E. S., Samaan, Z., Walter, S. D. & McDonald, S. D. (2013). Vitamin D deficiency and depression in adults: systematic review and meta-analysis. The British Journal of Psychiatry, 202(2), 100-107. https://doi.org/10.1192/bjp.bp.111.106666
Bikle, D., Bouillon, R., Thadhani, R. & Schoenmakers, I. (2017). Vitamin D metabolites in capitivity? Should we measure free or total 25(OH)D to asses vitamin D status? The Journal of Steroid Biochemistry and Molecular Biology, 173, 105-116. https://doi.org/10.1016/j.jsbmb.2017.01.007
Bivona, G., Lo Sasso, B., Gambino, C. M., Giglio, R. V., Scazzone, C., Agnello, L. & Ciaccio, M. (2021). The role of vitamin D as a biomarker in Alzheimer’s disease. Brain Sciences, 11(3), 334. https://doi.org/10.3390/brainsci11030334
Bouillon, R., Marcocci, C., Carmeliet, G., Bikle, D., White, J. H., Dawson-Hughes, B., Lips, P., Munns, C. F., Lazaretti-Castro, M., Giustina, A. & Bilezikian, J. (2019). Skeletal and extraskeletal actions of vitamin D: current evidence and outstanding questions. Endocrine Reviews, 40(4), 1109-1151. https://doi.org/10.1210/er.2018-00126
Brandão, D. J., Fontenelle, L. F., da Silva, S. A., Menezes, P. R. & Pastor-Valero, M. (2019). Depression and excess mortality in the elderly living in low and middle-income countries: systematic review and meta-analysis. Internation Journal of Geriatric Psychiatry, 34(1), 22-30. https://doi.org/10.1002/gps.5008
Cañón, M. & Buitrago-Gómez, Q. (2018). The research question in clinical practice: a guideline for its formulation. Revista Colombiana de Psiquiatría, 47(3), 193-200. https://doi.org/10.1016/j.rcp.2016.06.004
Cashman, K. D., Dowling, K. G., Škrabáková, Z., Gonzalez-Gross, M., Valtueña, J., De Henauw, S., Moreno, L., Damsgaard, C. T., Michaelsen, K. F., Mølgaard, C., Jorde, R., Grimnes, G., Moschonis, G., Mavrogianni, C., Manios, Y., Thamm, M., Mensink, G. B., Rabenberg, M., Busch, M. A., Cox, L., & Kiely, M. (2016). Vitamin D deficiency in Europe: pandemic? The American journal of clinical nutrition, 103(4), 1033-1044. https://doi.org/10.3945/ajcn.115.120873
Chesney, R. W. (2012). Theobald Palm and his remarkable observation: how the sunshine vitamin came to be recognized. Nutrientes, 4(1), 42-51. https://doi.org/10.3390/nu4010042
Damiano, R. F., Caruso, M. J. G., Cincoto, A. V., de Almeida Rocca, C. C., de Pádua Serafim, A., Bacchi, P., Guedes, B. F., Brunoni, A. R., Pan, P. M., Nitrini, R., Beach, S., Fricchione, G., Busatto, G., Miguel, E. C., Forlenza, O. V., & HCFMUSP COVID-19 Study Group. (2022). Post-COVID-19 psychiatric and cognitive morbidity: preliminary findings from a brazilian cohort study. General hospital psychiatry, 75, 38–45. https://doi.org/10.1016/j.genhosppsych.2022.01.002
Dejaeger, M., Antonio, L., Bouillon, R., Moors, H., Wu, F. C. W., O'Neill, T. W., Huhtaniemi, I. T., Rastrelli, G., Forti, G., Maggi, M., Casanueva, F. F., Slowikowska-Hilczer, J., Punab, M., Gielen, E., Tournoy, J., & Vanderschueren, D. (2022). Aging Men With Insufficient Vitamin D Have a Higher Mortality Risk: No Added Value of its Free Fractions or Active Form. The Journal of Clinical Endocrinology and Metabolism, 107(3), e1212-e1220. https://doi.org/10.1210/clinem/dgab743
Eyles, D. W., Smith, S., Kinobe, R., Hewison, M. & McGrath, J. J. (2005). Distribution of the vitamin D receptor and 1α-hydroxylase in human brain. Journal of Chemical Neuroanatomy, 29(1), 21-30. https://doi.org/10.1016/j.jchemneu.2004.08.006
Feldman, D., Krishnan, A. V., Swami, S., Giovannucci, E. & Feldman, B. J. (2014). The role of vitamin D in reducing cancer risk and progression. Nature Reviews Cancer, 14(5), 342–357. https://doi.org/10.1038/nrc3691
Felipe, L. R. S., Barbosa, K. S. S. & Virtuoso, J. S., Jr. (2022). Sintomatologia depressiva e mortalidade em idosos da América Latina: uma revisão sistemática com metanálise. Pan American Journal of Public Health, 46, e205. https://doi.org/10.26633/RPSP.2022.205
Fernandes de Abreu, D. A., Eyles, D. & Féron, F. (2009). Vitamin D, a neuro-immunomodulator: implications for neurodegenerative and autoimmune diseases. Psychoneuroendocrinology, 34(1), S265-S277. https://doi.org/10.1016/j.psyneuen.2009.05.023
Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J. L., Vos, T. & Whiteford, H. A. (2013). Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLOS Medicine, 10(11), e1001547. https://doi.org/10.1371/journal.pmed.1001547
Ferreira, C. E. S., Moreira, C. A. & Vasconcellos, L. S. (2020). Template for the laboratory’s report of 25-hydroxyvitamin D: recommendations form the Brazilian Society of Clinical Pathology/Laboratory Medicine (SBPC/ML) and the Brazilian Society of Endocrinology and Metabolism (SBEM). Jornal Brasileiro de Patologia e Medicina Laboratorial, 56(1), 1-2. https://doi.org/10.5935/1676-2444.20200052
Geng, C., Shaikh, A. S., Han, W., Chen, D., Guo, Y. & Jiang, P. (2019). Vitamin D and depression: mechanisms, determination and application. Asia Pacific Journal of Clinical Nutrition, 28(4), 689-694. https://doi.org/10.6133/apjcn.201912_28(4).0003
Giustina, A., Adler, R. A., Binkley, N., Bollerslev, J., Bouillon, R., Dawson-Hughes, B., Ebeling, P.R., Feldman, D., Formenti, A. M., Lazaretti-Castro, M., Marcocci, C., Rizzoli, R., Sempos, C. T. & Bilezikian, J. P. (2020). Consensus statement from 2nd International Conference on Controversies in Vitamin D. Reviews in Endocrine and Metabolic Disorders, 21(1), 89-116. https://doi.org/10.1007/s11154-019-09532-w
de Haan, P., Klein, H. C. & ´t Hart, B. A. (2017). Autoimmune aspects of neurodegenerative and psychiatric diseases: a template for innovative therapy. Frontiers in Psychiatry, 8, 46. https://doi.org/10.3389/fpsyt.2017.00046
Heath, A. K., Kim, I. Y., Hodge, A. M., English, D. R. & Muller, D.C. (2019). Vitamin D Status and Mortality: A Systematic Review of Observational Studies. International Journal of Environmental Research and Public Health, 16(3), 383. https://doi.org/10.3390/ijerph16030383
Hirani, V., Cumming, R. G., Naganathan, V., Blyth, F., Le Couteur, D. G., Handelsman, D. J., Waite, L. M. & Seibel, M. J. (2014). Associations between serum 25-hydroxyvitamin D concentrations and multiple health conditions, physical performance measures, disability, and all-cause mortality: The Concord Health and Ageing in Men Project. Jornal of the American Geriatrics Society, 62(3), 417-425. https://doi.org/10.1111/jgs.12693
Holick, M. F. (1996). Vitamin D and Bone Health. The Journal of Nutrition, 126(4), S1159-S1164. https://doi.org/10.1093/jn/126.suppl_4.1159S
Holick, M. F. (2007). Vitamin D deficiency. The New England Journal of Medicine, 357(3), 266-281. https://doi.org/10.1056/NEJMra070553
Holick, M. F. (2008). Vitamin D: a D-lightful health perspective. Nutrition Reviews, 66(10 Suppl 2), S182-S194. https://doi.org/10.1111/j.1753-4887.2008.00104.x
Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., Murad, M. H., Weaver, C. M. & Endocrine Society. (2011). Evaluation, treatment and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism, 96(7), 1911-1930. https://doi.org/10.1210/jc.2011-0385
Holick, M.F. (2023). The one-hundred-year anniversary of the discovery of the sunshine vitamin D3: historical, personal experience and evidende-based perspectives. Nutrientes, 15(3), 593. https://doi.org/10.3390/nu15030593
Institute of Medicine (US) Committee to review dietary reference intakes for vitamin D and calcium, Ross, A. C., Taylor, C. L., Yaktine, A. L., & Del Valle, H. B. (Eds.). (2011). Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press (US). https://doi.org/10.17226/13050
Jiang, Y., Liao, L., Li, J., Wang, L. & Xie, Z. (2020). Older age ir associated with decreased levels of VDR, CYP27B1, and CYP24A1 and increased levels of PTH in human parathyroid glands. International Journal of Endocrinology, 2020, 7257913. https://doi.org/10.1155/2020/7257913
Kouba, B. R., Camargo, A., Gil-Mohapel, J. & Rodrigues, A. L. S. (2022). Molecular basis underlying the therapeutic potential of vitamin D for the treatment of depression and anxiety. International Journal of Molecular Sciences, 23(13), 7077. https://doi.org/10.3390/ijms23137077
Laird, E., O´Halloran, A. M., Carey, D., Healy, M., O´Connor, D., Moore, P., Shannon, T., Molloy, A. M. & Kenny, R. A. (2018). The prevalence of Vitamin D Deficiency and the determinants of 25(OH)D concentration in older irish adults: data from The Irish Longitudinal Study on Ageing (TILDA). The Journals of Gerontology, 73(4), 519-525. https://doi.org/10.1093/gerona/glx168
Li, H., Sun, D., Wang, A., Pan, H., Feng, W., Ng, C. H., Ungvari, G. S., Tao, L., Li, X., Wang, W., Xiang, Y.T. & Guo, X. (2019). Serum 25-hydroxyvitamin D levels and depression in older adults: a dose-responde meta-analysis of prospective cohort Studies. The American Journal of Geriatric Psychiatry, 27(11), 1192-1202. https://doi.org/10.1016/j.jagp.2019.05.022
Lips, P. (2010). Worldwide status of vitamin D nutrition. The Journal of Steroid Biochemistry and Molecular Biology, 121(1-2), 297-300. https://doi.org/10.1016/j.jsbmb.2010.02.021
Lips, P., Cashman, K. D., Lamberg-Allardt, C., Bischoff-Ferrari, H. A., Obermayer-Pietsch, B., Bianchi, M. L., Stepan, J., El-Hajj Fuleihan, G. & Bouillon, R. (2019). Current vitamin D status in European and middle east countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. European Journal of Endocrinology, 180(4), 23-54. https://doi.org/10.1530/EJE-18-0736
Lucato, P., Solmi, M., Maggi, S., Bertocco, A., Bano, G., Trevisan, C., Manzato, E., Sergi, G., Schofield, P., Kouidrat, Y., Veronese, N. & Stubbs, B. (2017). Low vitamin D levels increase the risk of type 2 diabetes in older adults: A systematic review and meta-analysis. Maturitas, 100, 8-15. https://doi.org/10.1016/j.maturitas.2017.02.016
Malhi, G. S. & Mann, J. J. (2018). Depression. The Lancet, 392(10161), 2299-2312. https://doi.org/10.1016/S0140-6736(18)31948-2
McMollum, E. V., Simmonds, N., Becker, J. E. & Shipley, P. G. (1922). Studies on experimental rickets: an experimental demonstration of the existence of a vitamin which promotes calcium deposition. Journal of Biological Chemistry, 53(2), 293-312. https://doi.org/10.1016/S0021-9258(18)85783-0
Miller, A. H. & Raison, C. L. (2016). The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Reviews, 16(1), 22-34. https://doi.org/10.1038/nri.2015.5
Norman, A. W. (2006). Minireview: vitamin D Receptor: new assignments for an already busy receptor. Endocrinology, 147(12), 5542-5548. https://doi.org/10.1210/en.2006-0946
Otte, C., Gold, S. M., Penninx, B. W., Pariante, C. M., Etkin, A., Fava, M., Mohr, D. C. & Schatzberg, A. F. (2016). Major depressive disorder. Nature reviews. Disease primers, 2, 16065. https://doi.org/10.1038/nrdp.2016.65
Pludowski, P., Takacs, I., Boyanov, M., Belaya, Z., Diaconu, C. C., Mokhort, T., Zherdova, N., Rasa, I., Payer, J. & Pilz, S. (2022). Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement. Nutrients, 14(7), 1483. https://doi.org/10.3390/nu14071483
Prietl, B., Treiber, G., Pieber, T. R. & Amrein, K. (2013). Vitamin D and Immune Function. Nutrients, 5(7), 2502-2521. https://doi.org/10.3390/nu5072502
Ronaldson, A., Arias de la Torre, J., Gaughran, F., Bakolis, I., Hatch, S. L., Hotopf, M. & Dregan, A. (2022). Prospective associations between vitamin D and Depression in Middle-aged adults: findings from the UK Biobank cohort. Psychological Medicine, 52(10), 1866-1874. https://doi.org/10.1017/S0033291720003657
Scientific Advisory Committe on Nutrition (SACN). (2022). Vitamin D fortification working group, London – UK. https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition.
Souza, M. T., Silva, M. D. & Carvalho, R. (2010). Integrative review: what is it? How to do it? Einstein, 8(1), 102-106. https://doi.org/10.1590/S1679-45082010RW1134
Tian, H., Hu, Z., Xu, J. & Wang, C. (2022). The molecular pathophysiology of depression and the new therapeutics. MedComm, 3(3), e156. https://doi.org/10.1002/mco2.156
Tsai, S. J., Hsiao, Y. H., Liao, M. Y. & Lee, M. C. (2022). The influence of depressive mood on mortality in elderly with different health status: evidence from the Taiwan Longitudinal Study on Aging (TLSA). International Journal of Environmental Research and Public Health, 19(11), 6922. https://doi.org/10.3390/ijerph19116922
Tsuprykov, O., Chen, X., Hocher, C. F., Skoblo, R., Yin, L. & Hocher, B. (2018). Why should we measure free 25(OH) vitamin D? The Journal of Steroid Biochemistry and Molecular Biology, 180, 87-104. https://doi.org/10.1016/j.jsbmb.2017.11.014
van den Berg, K., Marijnissen, R. M., van den Brink, R. H. S., Naarding, P., Comijs, H. C. & Oude Voshaar, R. C. (2016). Vitamin D deficiency, depression course and mortality: Longitudinal results from the Netherlands Study on Depression in Older persons (NESDO). Journal of Psychosomatic Research, 83, 50-56. https://doi.org/10.1016/j.jpsychores.2016.03.004
White, J., Zaninotto, P., Walters, K., Kivimäki, M., Demakakos, P., Biddulph, J., Kumari, M., De Oliveira, C., Gallacher, J. & Batty, G. D. (2016). Duration of depressive symptoms and mortality risk: the English Longitudinal Study of Ageing (ELSA). The British Journal of Psychiatry, 208(4), 337-342. https://doi.org/10.1192/bjp.bp.114.155333
World Health Organization. (2021). Depression. Genebra, Suíça. https://who.int/news-room/fact-sheets/detail/depression
World Health Organization. (2022). Mental Health and COVID-19: early evidence of the pandemic’s impact. Genebra, Suíça.
https://who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1
Yao, H., Zhang, D., Yu, H., Shen, H., Liu, H., Meng, F., Wu, X., Zhang, G. & Wang, X. (2023). The microbiota-gut-brain axis in pathogenesis of depression: a narrative review. Physiology & Behavior, 260, 114056. https://doi.org/10.1016/j.physbeh.2022.114056
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