Determinants of adverse health outcomes in late-life depression:the role of vitamin D and frailty

Abstract

Older persons with a depression are at risk for vitamin D deficiency and physical health problems. Karen van den Berg studied the relationship between late-life depression, vitamin D, physical frailty and mortality.Among depressed older persons, vitamin D levels did not predict the course of depression. Lower vitamin D levels were associated with an increased risk to become physically frail or die. Specific depression characteristics did not influence the mortality risk, but physical frailty lead to a higher mortality risk. Two years later, vitamin D levels on average were decreased. This decrease was related to a worsening of physical frailty but not to the course of the depressive disorder. In depressed older persons, vitamin D supplementation might have a beneficial effect on the negative somatic health consequences associated with depression. Thus far, few studies, however, have focused on the effect of vitamin D on negative somatic health consequences besides the effect on depression.In clinical practice, adverse somatic health consequences of depression should be assessed and addressed in the treatment plan, since they negatively affect the prognosis. Since low vitamin D levels are common in depressed older persons, we recommend to actively strive for vitamin D supplementation in these population, even though a direct effect of vitamin D on depression is unlikely and the evidence for a link with adverse health consequences is still limited