Mental health literacy, folic acid and vitamin B12, and physical activity for the prevention of depression in older adults: randomised controlled trial

Authors:
WALKER Janine G., et al
Journal article citation:
British Journal of Psychiatry, 197(1), July 2010, pp.45-54.
Publisher:
Cambridge University Press

Depression in later life is common with 3.6-4.8% of people over 60 years reporting 12-month major depression, and 8-37.4% reporting significant depressive symptoms. In order to minimise the adverse impact of depression, effective, economical and accessible prevention strategies that are scalable to a community-wide level need to be developed. This study investigated the effectiveness of promoting physical activity, mental health literacy, and combined folic acid plus vitamin B12 as preventative interventions for an older population with elevated psychological distress. The study comprised a randomised clinical trial with a completely crossed 2x2x2 factorial design: (400 mcg/d folic acid + 100 mcg/d vitamin B12 v. placebo) x (physical activity v. nutrition promotion control) x (mental health literacy v. pain information control). The 909 participants, aged 60-74 years, were randomised into 1 of 8 intervention programmes which were delivered over 24 months. The interventions were delivered by mail with telephone calls. The main outcome was depressive symptoms on the Patient Health Questionnaire at 6 weeks, 6, 12 and 24 months. The drop-out rate was low (13.5%) from randomisation to 24-month assessment. The results showed that neither folic acid plus B12 nor physical activity reduced depressive symptoms at any time point. At 6 weeks, depressive symptoms were lower for the mental health literacy intervention compared with its control condition. The article concludes that mental health literacy had a transient effect on depressive symptoms. Other than this, none of the interventions significantly reduced symptoms relative to their comparator at 6 weeks or subsequently.

Subject terms:
mental health education, nutrition, older people, physical exercise, prevention, randomised controlled trials, depression;
Content type:
research
Location(s):
Australia
Links:
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ISSN online:
1472-1465
ISSN print:
0007-1250

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