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To: Ian@SI who wrote (6161)	5/21/2008 2:50:43 PM
From: Ian@SI	Respond to of 7143

medscape.com Release Date: May 12, 2008; Valid for credit through May 12, 2009 Credits Available Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™ for physicians; Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians Low Levels of Serum 25(OH)D Linked With Depression in Elderly Patients CME News Author: Laurie Barclay, MD CME Author: Laurie Barclay, MD May 12, 2008 — Low levels of serum 25-hydroxyvitamin D [25(OH)D] levels and increased parathyroid hormone (PTH) levels were linked with depression in elderly patients, according to the results of a large, population-based cohort study reported in the May issue of the Archives of General Psychiatry. "Depression has incidentally been related to altered levels of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH), but this relation has never been studied systematically," write Witte J.G. Hoogendijk, MD, PhD, from the Research Institute Neurosciences and the Center for Neurogenomics and Cognitive Research, VU University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. The study cohort for the Longitudinal Aging Study Amsterdam consisted of 1282 community residents aged 65 to 95 years who completed the self-reported Center for Epidemiologic Studies–Depression scale and diagnostic interviews based on the Diagnostic Interview Schedule. Levels of 25(OH)D and PTH were also measured, along with potentially confounding variables of age; sex; smoking status; body mass index; number of chronic conditions; serum creatinine concentrations; and explanatory variables such as season of data acquisition, level of urbanization, and physical activity levels. Compared with levels in 1087 control individuals, levels of 25(OH)D were 14% lower in 169 persons with minor depression and 14% lower in 26 persons with major depressive disorder (P < .001), and levels of PTH were 5% and 33% higher, respectively (P = .003). Based on the Center for Epidemiologic Studies Depression Scale, the severity of the depression was significantly associated with decreased serum 25(OH)D levels (P = .03) and increased serum PTH levels (P = .008). "The results of this large population-based study show an association of depression status and severity with decreased serum 25(OH)D levels and increased serum PTH levels in older individuals," the study authors write. Limitations of this study include observational design. "Long-term longitudinal studies with repeated assessments should be performed to explore the question of whether decreased 25(OH)D levels and increased PTH levels precede depression or follow it," the study authors conclude. "In other words, are these biological changes a cause or a consequence of depression?" This study is based on data collected in the context of the Longitudinal Aging Study Amsterdam, funded by the Netherlands Ministry of Health, the Hague. The Netherlands Ministry of Health and ZonMw supported this study. Arch Gen Psychiatry. 2008;65:508-512.