Total Plasma Homocysteine and Depressive Symptoms in Older Hispanics

Neuropsychiatric symptoms in cognitive decline and Alzheimer's disease: biomarker discovery using plasma proteomics

BACKGROUND AND OBJECTIVES

Neuropsychiatric symptoms (NPS) are common in older people with cognitive impairment and Alzheimer's disease (AD). No biomarkers to detect the related pathology or predict the clinical evolution of NPS are available yet. This study aimed to identify plasma proteins that may serve as biomarkers for NPS and NPS-related clinical disease progression.

METHODS

A panel of 190 plasma proteins was quantified using Luminex xMAP in the Alzheimer's Disease Neuroimaging Initiative cohort. NPS and cognitive performance were assessed at baseline and after 1 and 2 years. Logistic regression, receiver operating characteristic analysis and cross-validation were used to address the relations of interest.

RESULTS

A total of 507 participants with mild cognitive impairment (n=396) or mild AD dementia (n=111) were considered. Selected plasma proteins improved the prediction of NPS (area under the curve (AUC) from 0.61 to 0.76, p<0.001) and future NPS (AUC from 0.63 to 0.80, p<0.001) when added to a reference model. Distinct protein panels were identified for single symptoms. Among the selected proteins, ANGT, CCL1 and IL3 were associated with NPS at all three time points while CCL1, serum glutamic oxaloacetic transaminase and complement factor H were also associated with cognitive decline. The associations were independent of the presence of cerebral AD pathology as assessed using cerebrospinal fluid biomarkers.

CONCLUSIONS

Plasma proteins are associated with NPS and improve prediction of future NPS.

Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: a systematic review of randomized controlled trials

OBJECTIVES

This systematic review aimed to evaluate the efficacy of B vitamins and vitamin D therapy in improving the standard treatment of depression and anxiety disorders. We also aimed to gather the evidence supporting the recommendations for supplementation in clinical practice.

METHODS

Performed between March 2020 and September 2021, the main inclusion criteria were randomized controlled trials (RCTs), with patients ≥ 18 years old, both sexes, fulfilling target diagnoses of major depressive disorder (MDD), generalized anxiety disorder (GAD), or mild to severe depressive and anxiety symptoms. In addition, the RCTs were included if the scales to assess the severity of the symptoms were standardized rating scales in psychiatric. Trials that reported diagnoses of schizophrenia, perinatal depression, bipolar depression, sleep disorders, eating disorders, cancer, and multiple sclerosis in association with any of the mentioned diagnoses were excluded.

RESULTS

We identified 20 RCTs that matched all eligibility criteria, totaling 2,256 subjects, diagnosed with MDD, GAD, and depressive or anxiety symptoms. Supplementation with folic acid or L-methylfolate, B1, B12 or methylcobalamin, and vitamin D (in different doses and study duration) significantly decreased depression score scales by increasing response to standard pharmacological treatment or as monotherapy, including partial or complete remission. As for anxiety symptoms, the availability of results is limited to adjuvant vitamin D therapy.

DISCUSSION

B vitamins and vitamin D associated with other compounds also showed significant results, so the improvement in symptoms cannot be attributed strictly to those. Our results suggest that intervention with B vitamins and/or vitamin D may be an effective and well-tolerated adjuvant strategy for improving the symptoms of depression and anxiety, according to the patient's clinical status and nutritional biomarkers.

A healthy eating score is inversely associated with depression in older adults: results from the Chilean National Health Survey 2016-2017

OBJECTIVE

To investigate the relationship of a healthy eating score with depression in Chilean older adults.

DESIGN

Cross-sectional study.

SETTING

Older adults from the Chilean National Health Survey 2016-2017. Associations were analysed using complex samples multivariable logistic regressions adjusted for age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption and sleep duration), BMI and clinical conditions (hypertension, diabetes, hypercholesterolaemia and cardiovascular diseases).

PARTICIPANTS

The number of participants was 2031 (≥ 60 years). The Composite International Diagnostic Interview-Short Form was applied to establish the diagnosis of major depressive episode. Six healthy eating habits were considered to produce the healthy eating score (range: 0-12): consumption of seafood, whole grain, dairy, fruits, vegetables and legumes. Participants were categorised according to their final scores as healthy (≥ 9), average (5-8) and unhealthy (≤ 4).

RESULTS

Participants with a healthy score had a higher educational level, physical activity and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0·28, (95 % CI 0·10, 0·74)). Food items that contributed the most to this association were legumes (15·2 %) and seafood (12·7 %).

CONCLUSION

Older adults classified in the healthiest healthy eating score, characterised by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population.