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Effect of long-term supplementation with folic acid and B vitamins on risk of depression in older women.

Abstract

BACKGROUND

Homocysteine-lowering nutrients may have preventive/ameliorative roles in depression.

AIMS

To test whether long-term B-vitamin/folate supplementation reduces depression risk.

METHOD

Participants were 4331 women (mean age 63.6 years), without prior depression, from the Women's Antioxidant and Folic Acid Cardiovascular Study - a randomised controlled trial of cardiovascular disease prevention among 5442 women. Participants were randomly assigned to receive a combination of folic acid (2.5 mg/d), vitamin B6 (50 mg/d) and vitamin B12 (1 mg/d) or a matching placebo. Average treatment duration was 7 years. The outcome was incident depression, defined as self-reported physician/clinician-diagnosed depression or clinically significant depressive symptoms.

RESULTS

There were 524 incident cases. There was no difference between active v. placebo groups in depression risk (adjusted relative risk 1.02, 95% CI 0.86-1.21, P = 0.81), despite significant homocysteine level reduction.

CONCLUSIONS

Long-term, high-dose, daily supplementation with folic acid and vitamins B6 and B12 did not reduce overall depression risk in mid-life and older women.

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  • Authors+Show Affiliations

    ,

    Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.

    ,

    Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.

    ,

    Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.

    ,

    Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.

    ,

    Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.

    Olivia I. Okereke, MD, SM, Channing Division of Network Medicine, Boston, Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Nancy R. Cook, ScD, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Christine M. Albert, Martin Van Denburgh, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Julie E. Buring, ScD, JoAnn E. Manson, MD, DrPH, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.

    Source

    MeSH

    Aged
    Depression
    Dietary Supplements
    Drug Therapy, Combination
    Female
    Folic Acid
    Follow-Up Studies
    Humans
    Middle Aged
    Risk Factors
    Self Report
    Vitamin B 12
    Vitamin B 6

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25573400

    Citation

    Okereke, Olivia I., et al. "Effect of Long-term Supplementation With Folic Acid and B Vitamins On Risk of Depression in Older Women." The British Journal of Psychiatry : the Journal of Mental Science, vol. 206, no. 4, 2015, pp. 324-31.
    Okereke OI, Cook NR, Albert CM, et al. Effect of long-term supplementation with folic acid and B vitamins on risk of depression in older women. Br J Psychiatry. 2015;206(4):324-31.
    Okereke, O. I., Cook, N. R., Albert, C. M., Van Denburgh, M., Buring, J. E., & Manson, J. E. (2015). Effect of long-term supplementation with folic acid and B vitamins on risk of depression in older women. The British Journal of Psychiatry : the Journal of Mental Science, 206(4), pp. 324-31. doi:10.1192/bjp.bp.114.148361.
    Okereke OI, et al. Effect of Long-term Supplementation With Folic Acid and B Vitamins On Risk of Depression in Older Women. Br J Psychiatry. 2015;206(4):324-31. PubMed PMID: 25573400.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of long-term supplementation with folic acid and B vitamins on risk of depression in older women. AU - Okereke,Olivia I, AU - Cook,Nancy R, AU - Albert,Christine M, AU - Van Denburgh,Martin, AU - Buring,Julie E, AU - Manson,JoAnn E, Y1 - 2015/01/08/ PY - 2014/03/14/received PY - 2014/08/26/accepted PY - 2015/1/10/entrez PY - 2015/1/13/pubmed PY - 2015/12/15/medline SP - 324 EP - 31 JF - The British journal of psychiatry : the journal of mental science JO - Br J Psychiatry VL - 206 IS - 4 N2 - BACKGROUND: Homocysteine-lowering nutrients may have preventive/ameliorative roles in depression. AIMS: To test whether long-term B-vitamin/folate supplementation reduces depression risk. METHOD: Participants were 4331 women (mean age 63.6 years), without prior depression, from the Women's Antioxidant and Folic Acid Cardiovascular Study - a randomised controlled trial of cardiovascular disease prevention among 5442 women. Participants were randomly assigned to receive a combination of folic acid (2.5 mg/d), vitamin B6 (50 mg/d) and vitamin B12 (1 mg/d) or a matching placebo. Average treatment duration was 7 years. The outcome was incident depression, defined as self-reported physician/clinician-diagnosed depression or clinically significant depressive symptoms. RESULTS: There were 524 incident cases. There was no difference between active v. placebo groups in depression risk (adjusted relative risk 1.02, 95% CI 0.86-1.21, P = 0.81), despite significant homocysteine level reduction. CONCLUSIONS: Long-term, high-dose, daily supplementation with folic acid and vitamins B6 and B12 did not reduce overall depression risk in mid-life and older women. SN - 1472-1465 UR - https://www.unboundmedicine.com/medline/citation/25573400/full_citation L2 - https://www.cambridge.org/core/product/identifier/S0007125000278811/type/journal_article DB - PRIME DP - Unbound Medicine ER -