Vitamin D supplementation for the prevention of depression and poor physical function in older persons: the D-Vitaal study, a randomized clinical trial
What this study found
Vitamin D3 supplementation did not improve depressive symptoms, physical performance, or most secondary outcomes over 12 months versus placebo. The primary outcomes showed no significant between-group differences, with interaction terms P > 0.10. Serum 25(OH)D rose substantially in the vitamin D3 arm at 6 months (85 ± 16 nmol/L vs 43 ± 18 nmol/L in placebo; P < 0.001), confirming biological exposure, but this did not translate into clear clinical benefit. A higher baseline 25(OH)D subgroup showed fewer functional limitations with vitamin D3 (OR = 0.21; 95% CI: 0.05, 0.88; P = 0.032), but…
- Study & population
- Randomized clinical trial in community-dwelling older adults at risk of depression and poor physical functioning in Amsterdam and surrounding areas, the Netherlands, conducted from 2013 to 2016.
- Intervention
- Participants in the active arm received vitamin D3 1200 IU/day for 12 months, given as 3 oral tablets of 400 IU cholecalciferol (Devaron), compared with identical placebo tablets.
- Key limitation
- The active arm was modest in size, limiting power for clinical outcomes and subgroup analyses.
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Open PDFOriginal abstract
ABSTRACT Background Depressive symptoms and impaired physical functioning are prevalent among older adults. Supplementation with vitamin D might improve both conditions, particularly in persons with low vitamin D status. Objective The D-Vitaal study primarily aimed to investigate the effect of vitamin D supplementation on depressive symptoms, functional limitations, and physical performance in a high-risk older population with low vitamin D status. Secondary aims included examining the effect of vitamin D supplementation on anxiety symptoms, cognitive functioning, mobility, handgrip strength, and health-related quality of life. Methods This study was a randomized placebo-controlled trial with 155 participants aged 60–80 y who had clinically relevant depressive symptoms, ≥1 functional limitations, and serum 25-hydroxyvitamin D [25(OH)D] concentrations of 15–50/70 nmol/L (depending on season). Participants received 1200 IU/d vitamin D3 (n = 77) or placebo tablets (n = 78) for 12 mo. Serum 25(OH)D was measured at baseline and 6 mo; outcomes were assessed at baseline, 6 mo, and 12 mo. Linear mixed-models analyses were conducted to assess the effect of the intervention. Results The supplementation increased serum 25(OH)D concentrations in the intervention group to a mean ± SD of 85 ± 16 nmol/L compared with 43 ± 18 nmol/L in the placebo group after 6 mo (P < 0.001). No relevant differences between the treatment groups were observed regarding depressive symptoms, functional limitations, physical performance, or any of the secondary outcomes. Conclusions Supplementation with 1200 IU/d vitamin D for 12 mo had no effect on depressive symptoms and physical functioning in older persons with relatively low vitamin D status, clinically relevant depressive symptoms, and poor physical functioning. This trial is registered with the Netherlands Trial Register (www.trialregister.nl) under NTR3845.