Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 4/6/2004
Publication Date: 10/1/2004
Citation: Ramos, M.I., Allen, L.H., Haan, M.N., Green, R., Miller, J.W. 2004. Plasma folate concentrations are associated with depressive symptoms in elderly Latina women despite folic acid fortification. American Journal of Clinical Nutrition. 80:1024-1028. Interpretive Summary: Lower plasma folate concentrations are known to be associated with higher risk of depression. This objective of this research was to determine if this association still exists now that folic acid fortification of flour has raised folate intakes in the U.S. In this study of 627, and 883 female elderly Latinos in California, participants in the lowest third of plasma folate concentrations were twice as likely to have depressive symptoms those in the highest tertile. Despite folic acid fortification, lower plasma folate is still associated with more symptoms of depression in these women.
Technical Abstract: BACKGROUND: A relation between low folate status and depression has been recognized since the 1960's. Since 1998, flour in the United States has been fortified with folic acid, and the prevalence of folate deficiency has decreased dramatically. OBJECTIVE: We investigated whether, in this era of folic acid fortification, low folate status is a determinant of depressive symptoms in a cohort of elderly Latinos (aged >/=60y) participating in the Sacramento Area Latino Study on Aging (SALSA). DESIGN: In a cross-sectional logistic regression analysis of data from SALSA (n=627 M, 883F), odds ratios (ORs) were ascertained for elevated depressive symptoms (Center for Epidemiologic Studies Depression Scale (CES-D) score >/=16) among tertiles of plasma folate. Depressive symptoms were assessed by using the CES-D. Plasma folate concentrations were determined by radioassay. RESULTS: The prevalence of folate deficiency (plasma folate </=6.8 nmol/L) in the SALSA population was <1%. For men, no significant association between folate tertile and high CES-D score was observed. The adjusted OR for high CES-D score in women in the lowest tertile of folate was 2.04 (95% CI: 1.38, 3.02), which was significantly different from that in women in the highest tertile of folate (P<0.001). CONCLUSION: These data indicate that despite folic acid fortifcation, low folate status is associated with depressive symptoms in elderly Latina women (but not elderly Latino men).