Effects of dietary supplements on depressive symptoms in older patients: a randomised double-blind placebo-controlled trial.
ABSTRACT The effect of nutritional supplements on mental health in older patients has received little attention so far. The aims of this trial were therefore to test the effect of nutritional support on older patient's depressive symptoms and cognitive function.
In this prospective, double-blind, placebo-controlled study, we randomly assigned 225 hospitalised acutely ill older patients to receive either normal hospital diet plus 400 mL oral nutritional supplements (106 subjects) or normal hospital diet plus a placebo (119 subjects) daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal for energy and 100% of the Reference Nutrient Intakes for a healthy old person for vitamins and minerals. Outcome measures were 6 weeks and 6 months changes in nutritional status, depressive symptoms and cognitive state.
Randomisation to the supplement group led to a significant increase in red-cell folate and plasma vitamin B12 concentrations, in contrast to a decrease seen in the placebo group. There were significant differences in symptoms of depression scores in the supplement group compared with the placebo group at 6 months (p = 0.021 for between groups difference). The effect of supplement was seen in all patient groups including those with no symptoms of depression, mild depression and those with severe depression (p = 0.007). There was no evidence of a difference in cognitive function scores at 6 months.
Oral nutritional supplementation of hospitalised acutely ill older patients led to a statistically significant benefit on depressive symptoms.
- [show abstract] [hide abstract]
ABSTRACT: The study tested whether nutritional support of older patients during acute illness leads to a clinical benefit. In this randomized, double-blind, placebo-controlled study, we randomly assigned 445 hospitalized patients aged 65 to 92 years to receive either a normal hospital diet plus 400 mL oral nutritional supplements (223 subjects) or a normal hospital diet plus a placebo (222 subjects) daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal of energy and 100% of the Reference Nutrient Intakes for vitamins and minerals for a healthy older person. Patients had three assessments: at baseline, at 6 weeks, and at 6 months post-randomization. Outcome measures were 6 months of disability, non-elective readmission and length of hospital stay, discharge destination, morbidity, and mortality. Randomization to the supplement group led to a significant improvement in nutritional status. Over 6 months, 65 patients (29%) in the supplements group were readmitted to the hospital compared with 89 patients (40%) in the placebo group (adjusted hazard ratio 0.68 [95% confidence interval 0.49-0.94]). The mean length of hospital stay was 9.4 days in the supplements group compared with 10.1 days in the placebo group. Thirty-two people (14%) died in the supplement group compared with 19 people (9%) in the placebo group at 6 months (adjusted hazard ratio 1.65 [95% confidence interval, 0.93-2.92]). Oral nutritional supplementation of acutely ill patients improved nutritional status and led to a statistically significant reduction in the number of non-elective readmissions.The American journal of medicine 09/2006; 119(8):693-9. · 4.47 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Deficiencies of cobalamin and folate may play a causal role in the development or exacerbation of psychiatric illnesses. We compared cobalamin and folate levels in newly admitted psychiatric patients to mentally healthy controls and assessed their correlation with various psychiatric conditions. All patients consecutively admitted to a psychiatric hospital were examined for serum cobalamin and folate levels. Controls were obtained from a population with no known mental illness. Values were considered to be below normal if cobalamin was <223 pg/ml and folate <3.1 ng/ml. The 224 newly admitted patients did not differ significantly from controls, both with regard to the mean cobalamin level and to the prevalence of lower than normal levels. About 30% of patients had low folate values compared to 2.5% in the control group (P<0.0001). Mean folate level in controls was significantly higher than in patients (P<0.0001), where a positive correlation was found between low folate levels and depression. The results of our study suggest that folate levels be assessed in patients admitted to psychiatric wards, especially in those with depression. Further study is needed to evaluate the role of folate and cobalamin in psychiatric illness.Clinical Nutrition 02/2006; 25(1):60-7. · 3.30 Impact Factor
- Nutrition 01/2000; 16(7-8):544-6. · 2.86 Impact Factor