Effect of Micronutrient Supplementation on Mood in Nursing Home Residents

Abstract

One third of older people in nursing and/or residential homes have significant symptoms of depression. In younger people, deficiencies in selenium, vitamin C and folate are associated with depression. This study examines the association between micronutrient status and mood before and after supplementation. The objective was to determine whether the administration of selenium, vitamin C and folate improved mood in frail elderly nursing home residents. Mood was assessed using the Hospital Anxiety and Depression rating scale (HAD), and Montgomery-Åsberg Depression Rating Scale (MADRS). Micronutrient supplementation was provided for 8 weeks in a double-blinded randomised controlled trial. Significant symptoms of depression (29%) and anxiety (24%) were found at baseline. 67% of patients had low serum concentrations of vitamin C, but no-one was below the reference range for selenium. Depression was significantly associated with selenium levels, but not with folate or vitamin C levels. No individual with a HAD depression score of ≧8, had selenium levels >1.2 µM. In those patients with higher HAD depression scores, there was a significant reduction in the score and a significant increase in serum selenium levels after 8 weeks of micronutrient supplementation. Placebo group scores were unchanged. This small study concluded that depression was associated with low levels of selenium in frail older individuals. Following 8 weeks of micronutrient supplementation, there was a significant increase in selenium levels and improved symptoms of depression occurred in a subgroup.

Selenium exposure and depressive symptoms: The Coronary Artery Risk Development in Young Adults Trace Element Study

“…Collectively, the studies by Benton & Cook (1991), Hawkes & Hornbostel (1996), Finley & Penland (1998), Rayman et al (2005), and Gosney et al (2008) support this concept: improvements in mood or depression scores with supplementation were noted when the participants’ baseline selenium status was low, and no improvements were observed when the baseline selenium status was judged higher (Hawkes & Hornbostel (1996), Rayman et al (2005)). …”

“…In addition to having cardiometabolic effects, there has been suggestion in review articles that selenium has potentially mood modulating effects (Bodnar & Wisner, 2005; Kaplan et al, 2007; Leung & Kaplan, 2009) as a few small studies (Benton & Cook, 1991; Finley & Penland, 1998; Gosney et al., 2008) do suggest a beneficial effect on mood. Recently, lower selenium levels were associated with higher depressive symptoms in an elderly, rural Chinese cohort (Gao et al, 2012) after adjusting for demographic and medical conditions.…”

Selenium and manganese in depression – preclinical and clinical studies

“…Gosney et al [20] observed that an 8-week course of selenium supplementation significantly improved mood in both residential and nursing home residents. This effect was allied with increased concentration of selenium in the serum.…”

Dietary and botanical anxiolytics

“…Further, selenium added to the diet also reduced the anxiety in hospitalized patients who are elderly, cancer patients, and/or HIV patients [47–49]. …”