Vitamin D deficiency, depression course and mortality: Longitudinal results from the Netherlands Study on Depression in Older persons (NESDO)

• Vitamin D status does not predict course of late-life depression.
• Vitamin D deficiency predicts mortality among depressed older patients.
• A causal role for vitamin D in the pathophysiology of depression seems unlikely.
• An effect of severe vitamin D deficiency on depression course cannot be excluded.

ObjectiveTo study the effect of vitamin D levels on depression course and remission status after two years, as well as attrition and mortality, in an older cohort.MethodsThis study was part of the Netherlands Study on Depression in Older persons (NESDO), a prospective cohort study. 367 depressed older persons (≥ 60 years) were included. Baseline vitamin D status, reasons for loss to follow up, clinical depression diagnosis at two-year follow up, and six-monthly symptom scores were obtained. Data were analyzed by logistic regression and random coefficient models and adjusted for confounders of vitamin D status.ResultsVitamin D had no effect on the course of depression or remission, except for a trend towards lower remission rates in the severely deficient subgroup (25-(OH) vitamin D < 25 nmol/l). Patients who died during follow up had significantly lower 25-(OH) vitamin D and 1,25-(OH)2 vitamin D levels than patients with continued participation.ConclusionsFor the total sample we found no effect of vitamin D levels on the course of depression or remission rates. However, we did find an effect of lower vitamin D levels on mortality. This strengthens the interpretation of vitamin D deficiency being a marker for poor somatic health status. The trend towards lower remission rates in the severely deficient subgroup raises the question whether this group could benefit from supplementation. Randomized controlled trials are necessary to study this.