Effects of Two-Year Vitamin B 12 and Folic Acid Supplementation on Depressive Symptoms and Quality of Life in Older Adults with Elevated Homocysteine Concentrations: Additional Results from the B-PROOF Study, an RCT

• Published in: Nutrients 2016-11, Vol.8 (11)
• Main Authors: de Koning, Elisa J, van der Zwaluw, Nikita L, van Wijngaarden, Janneke P, Sohl, Evelien, Brouwer-Brolsma, Elske M, van Marwijk, Harm W J, Enneman, Anke W, Swart, Karin M A, van Dijk, Suzanne C, Ham, Annelies C, van der Velde, Nathalie, Uitterlinden, André G, Penninx, Brenda W J H, Elders, Petra J M, Lips, Paul, Dhonukshe-Rutten, Rosalie A M, van Schoor, Natasja M, de Groot, Lisette C P G M
• Format: Article
• Language: English
• Subjects: Affect; Age Factors; Aged; analysis of covariance; Biomarkers - blood; Depression - diagnosis; Depression - etiology; Depression - prevention & control; Depression - psychology; Dietary Supplements; Double-Blind Method; Drug Combinations; elderly; Female; folic acid; Folic Acid - administration & dosage; homocysteine; Homocysteine - blood; Humans; Hyperhomocysteinemia - blood; Hyperhomocysteinemia - diagnosis; Hyperhomocysteinemia - drug therapy; Male; mental depression; Netherlands; placebos; Psychiatric Status Rating Scales; Quality of Life; randomized clinical trials; Risk Factors; Time Factors; Treatment Outcome; Up-Regulation; Vitamin B 12 - administration & dosage; vitamin D
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu8110748

Lowering elevated plasma homocysteine (Hcy) concentrations by supplementing vitamin B and folic acid may reduce depressive symptoms and improve health-related quality of life (HR-QoL) in older adults. This study aimed to test this hypothesis in a randomized controlled trial. Participants ( = 2919, ≥65 years, Hcy concentrations ≥12 µmol/L) received either 500 µg vitamin B and 400 µg folic acid daily or placebo for two years. Both tablets contained 15 µg vitamin D₃. Depressive symptoms were measured with the Geriatric Depression Scale-15 (GDS-15). HR-QoL was assessed with the SF-12 Mental and Physical component summary scores and the EQ-5D Index score and Visual Analogue Scale. Differences in two-year change scores were analyzed with Analysis of Covariance (ANCOVA). Hcy concentrations decreased more in the intervention group, but two-year change scores of the GDS-15 and three of four HR-QoL measures did not differ between groups. The EQ-5D Index score declined less in the intervention group than in the placebo group (mean change 0.00 vs. -0.02, = 0.004). In conclusion, two-year supplementation with vitamin B and folic acid in older adults with hyperhomocysteinemia showed that lowering Hcy concentrations does not reduce depressive symptoms, but it may have a small positive effect on HR-QoL.