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Accepted manuscript

Low vitamin B12 but not folate is associated with incident depressive symptoms in community-dwelling older adults: a 4 year longitudinal study

Published online by Cambridge University Press:  13 December 2021

Eamon Laird*
Affiliation:
The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland School of Medicine, Trinity College Dublin, Ireland
Aisling M. O’Halloran
Affiliation:
The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland School of Medicine, Trinity College Dublin, Ireland
Anne M Molloy
Affiliation:
School of Medicine, Trinity College Dublin, Ireland
Martin Healy
Affiliation:
Department of Biochemistry & Clinical Pathology, St James’s Hospital, Dublin, Ireland
Belinda Hernandez
Affiliation:
The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland School of Medicine, Trinity College Dublin, Ireland
Deirdre O’Connor
Affiliation:
The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland School of Medicine, Trinity College Dublin, Ireland
Rose Anne Kenny
Affiliation:
The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland School of Medicine, Trinity College Dublin, Ireland
Robert Briggs
Affiliation:
The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland School of Medicine, Trinity College Dublin, Ireland
*
Corresponding Author: Eamon Laird, The Irish Longitudinal Study on Ageing (TILDA), Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland. Email: lairdea@tcd.ie Tel: +353 1 8964342
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Abstract

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The objective was to examine the prospective relationship between folate and vitamin B12 (B12) status and incident depressive symptoms in a representative cohort of community-dwelling older people. This was a longitudinal study utilising the Irish Longitudinal Study on Aging (n =3,849 aged ≥50 years) and investigated the relationship between blood plasma folate and B12 levels at baseline (wave 1) and incident depressive symptoms at 2 and 4 years (waves 2 and 3). Participants with depression at wave 1 were excluded. A score ≥9 on the Center for Epidemiologic Studies Depression Scale-8 at wave 2 or 3 was indicative of incident depressive symptoms. Plasma B12 and folate concentrations were determined by microbiological assay. B12 status profiles (pmol/l) were defined as: <185, deficient-low; 185 - <258, low normal; >258 - 601, normal and >601 high. Folate status profiles (nmol/l) were defined as: ≤10.0, deficient-low; >10 - 23.0, low normal; >23.0 - 45.0, normal; >45.0, high. Logistic regression models reporting odds ratios were used to analyse the longitudinal association of B-vitamin categories with incident depression. Both B12 and folate plasma concentrations were lower in the group with incident depressive symptoms vs. non depressed (folate: 21.4 vs. 25.1 nmol/L; P=0.0003); (B12: 315.7 vs. 335.9 pmol/L; P=0.0148). Regression models demonstrated that participants with deficient-low B12 status at baseline had a significantly higher likelihood of incident depression four years later (odds ratio 1.51, 95% CI 1.01-2.27, P=0.043). This finding remained robust after controlling for relevant covariates including physical activity, chronic disease burden, vitamin D status. cardiovascular disease and antidepressant use. No associations of folate status with incident depression were observed. Older adults with deficient-low B12 status had a 51% increased likelihood of developing depressive symptoms over 4 years. Given the high rates of B12 deficiency, these findings are important and highlight the need to further explore the low cost benefits of optimising vitamin B12 status for depression in older adults.

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Copyright
© The Authors 2021
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Low vitamin B12 but not folate is associated with incident depressive symptoms in community-dwelling older adults: a 4 year longitudinal study
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Low vitamin B12 but not folate is associated with incident depressive symptoms in community-dwelling older adults: a 4 year longitudinal study
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