Skip to main content

Mediterranean diet and depressive symptoms among older adults over time

Abstract

Objective

To examine whether adherence to a Mediterranean-based dietary pattern is predictive of depressive symptoms among older adults.

Design

Generalized estimating equation models were used to test the association between a Mediterranean-based dietary pattern and depressive symptoms over time. Models were adjusted for age, sex, race, education, income, widowhood, antidepressant use, total calorie intake, body mass index, smoking, alcohol consumption, number of self-reported medical conditions, cognitive function, and physical disability.

Setting

Chicago, Illinois.

Participants

Community-dwelling participants (n=3502) of the Chicago Health and Aging Project aged 65+ years (59% African American) who had no evidence of depression at the baseline.

Measurements

Adherence to a Mediterranean-based dietary pattern was assessed by the MedDietScore. Dietary evaluation was performed with a food frequency questionnaire at baseline and related to incident depression as measured by the presence of four or more depressive symptoms from the 10-item version of the Center for Epidemiologic Studies Depression scale.

Results

Over an average follow-up of 7.2 years, greater adherence to a Mediterranean-based diet was associated with a reduced number of newly occurring depressive symptoms (parameter estimate = −0.002, standard error = 0.001; p = 0.04). The annual rate of developing depressive symptoms was 98.6% lower among persons in the highest tertile of a Mediterranean-based dietary pattern compared with persons in the lowest tertile group.

Conclusion

Our results support the hypothesis that adherence to a diet comprised of vegetables, fruits, whole grains, fish, and legumes may protect against the development of depressive symptoms in older age.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    He W, Sengupta M, Velkoff VA, DeBarros KA (2005) U.S. Census Bureau, Current Population Reports, P23–209, 65+ in the United States, 2005. Washington, D.C.: U.S. Government Printing Office

    Google Scholar 

  2. 2.

    Djernes JK (2006) Prevalence and predictors of depression in populations of elderly: A review. Acta Psychiatr Scand 113(5):372

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Beekman AT, Copeland JR, Prince MJ (1999) Review of community prevalence of depression in later life. Br J Psychiatry 174:307–311

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Cole MG, Bellavance F, Mansour A (1999) Prognosis of depression in elderly community and primary care populations: A systematic review and meta-analysis. Am J Psychiatry 156(8):1182–1189

    PubMed  CAS  Google Scholar 

  5. 5.

    Mills TL. (2001) Comorbid depressive symptomatology: Isolating the effects of chronic medical conditions on self-reported depressive symptoms among community-dwelling older adults. Soc Sci Med 53(5):569–578

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Skarupski KA, Mendes de Leon CF, Bienias JL, Barnes LL, Everson-Rose SA, et al (2005) Black-white differences in depressive symptoms among older adults over time. J Gerontol B Psychol Sci Soc Sci 60(3):P136–42

    PubMed  Article  Google Scholar 

  7. 7.

    Harris T, Cook D, Victor C, DeWilde S, Beighton C (2006) Onset and persistence of depression in older people—results from a 2-year community follow-up study. Age Ageing 35(1):25–32

    PubMed  Article  Google Scholar 

  8. 8.

    Everson-Rose SA, Skarupski KA, Bienias JL, Wilson RS, Evans DA, et al (2005) Do depressive symptoms predict declines in physical performance in an elderly, biracial population? Psychosom Med 67(4):609–615

    PubMed  Article  Google Scholar 

  9. 9.

    Whooley MA, Browner WS (1998) Association between depressive symptoms and mortality in older women. Study of osteoporotic fractures research group. Arch Intern Med 158(19):2129

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Koenig HG (1999) Late-life depression: How to treat patients with comorbid chronic illness. Interview by Alice V. Luddington. Geriatrics 54(5):56–61

    PubMed  CAS  Google Scholar 

  11. 11.

    Sofi F, Abbate R, Gensini G, Casini A (2010) Accruing evidence on benefits of adherence to the Mediterranean diet on health: An updated systematic review and meta-analysis. Am J Clin Nutr 92(5):1189–1196

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Berr C, Portet F, Carriere I, Akbaraly T, Feart C, et al (2009) Olive oil and cognition: Results from the Three-City Study. Dement Geriatr Cogn Disord 28(4):357–364

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Féart C, Samieri C, Rondeau V, Amieva H, Portet F, et al (2009) Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA 302(6):638–648

    PubMed  Article  Google Scholar 

  14. 14.

    Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA (2006) Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol 59(6):912–921

    PubMed  Article  Google Scholar 

  15. 15.

    Scarmeas N, Stern Y, Mayeux R, Manly JJ, Schupf N, et al (2009) Mediterranean diet and mild cognitive impairment. Arch Neurol 66(2):216–225

    PubMed  Article  Google Scholar 

  16. 16.

    Solfrizzi V, Colacicco AM, D’Introno A, Capurso C, Torres F, et al (2006) Dietary intake of unsaturated fatty acids and age-related cognitive decline: A 8.5-year follow-up of the Italian longitudinal study on aging. Neurobiol Aging 27(11):1694–1704

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Tangney CC, Kwasny MJ, Li H, Wilson RS, Evans DA, et al (2011) Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population. Am J Clin Nutr 93(3):601–607

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Bosetti C, Gallus S, Trichopoulou A, Talamini R, Franceschi S, et al (2003) Influence of the Mediterranean diet on the risk of cancers of the upper aerodigestive tract. Cancer Epidemiol Biomarkers Prev 12(10):1091–1094

    PubMed  Google Scholar 

  19. 19.

    de Lorgeril M, Salen P (2007) Modified Cretan Mediterranean diet in the prevention of coronary heart disease and cancer: An update. World Rev Nutr Diet 97:1–32

    PubMed  Google Scholar 

  20. 20.

    Dixon LB, Subar A, Peters U, Weissfeld J, Bresalier R, et al (2007) Adherence to the USDA food guide, DASH eating plan, and Mediterranean dietary pattern reduces risk of colorectal adenoma. J Nutr 137(11):2443–2450

    PubMed  CAS  Google Scholar 

  21. 21.

    de Lorgeril M, Salen P (2006) The Mediterranean-style diet for the prevention of cardiovascular diseases. Public Health Nutr 9(1A):118–123

    PubMed  Article  Google Scholar 

  22. 22.

    Panagiotakos D, Pitsavos C, Arvaniti F, Stefanadis C (2007) Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; The accuracy of the MedDietScore. Prev Med 44(4):335–340

    PubMed  Article  Google Scholar 

  23. 23.

    Chrysohoou C, Liontou C, Aggelopoulos P, Kastorini C, Panagiotakos D, et al (2011) Mediterranean diet mediates the adverse effect of depressive symptomatology on shortterm outcome in elderly survivors from an acute coronary event. Cardiol Res and Pract 2011:429487–429487

    Google Scholar 

  24. 24.

    Barzi F, Woodward M, Marfisi RM, Tavazzi L, Valagussa F, et al (2003) Mediterranean diet and all-causes mortality after myocardial infarction: Results from the GISSIprevenzione trial. Eur J Clin Nutr 57(4):604–611

    PubMed  Article  CAS  Google Scholar 

  25. 25.

    Fung T, Rexrode K, Mantzoros C, Manson J, Willett W, et al (2009) Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 119(8):1093–1100

    PubMed  Article  Google Scholar 

  26. 26.

    Knoops KTB, de Groot K, Daan, Perrin A, Moreiras-Varela O, Menotti A, et al (2004) Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE project. JAMA 292(12):1433–1439

    PubMed  Article  Google Scholar 

  27. 27.

    Mitrou P, Kipnis V, Thiébaut ACM, Reedy J, Subar A, et al (2007) Mediterranean dietary pattern and prediction of all-cause mortality in a US population: Results from the NIHAARP diet and health study. Arch Intern Med 167(22):2461–2468

    PubMed  Article  Google Scholar 

  28. 28.

    Trichopoulou A, Costacou T, Bamia C, Trichopoulos D (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348(26):2599–2608

    PubMed  Article  Google Scholar 

  29. 29.

    Sánchez-Villegas A, Delgado-Rodríguez M, Alonso A, Schlatter J, Lahortiga F, et al (2009) Association of the mediterranean dietary pattern with the incidence of depression: The seguimiento universidad de Navarra/University of Navarra follow-up (SUN) cohort. Arch Gen Psychiatry 66(10):1090–1098

    PubMed  Article  Google Scholar 

  30. 30.

    Morris MC, Colditz GA, Evans DA (1998) Response to a mail nutritional survey in an older bi-racial community population. Ann Epidemiol 8(5):342

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Morris MC, Tangney CC, Bienias JL, Evans DA, Wilson RS (2003) Validity and reproducibility of a food frequency questionnaire by cognition in an older biracial sample. Am J Epidemiol 158(12):1213

    PubMed  Article  Google Scholar 

  32. 32.

    Kohout FJ, Berkman LF, Evans DA, Cornoni-Huntley J (1993) Two shorter forms of the CES-D (center for epidemiological studies depression) depression symptoms index. J Aging Health 5(2):179–193

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Radloff LS (1977) The CES-D scale: A self-report depression scale for research in the general population. Appl Psych Meas 1(3):385–401

    Article  Google Scholar 

  34. 34.

    Irwin M, Artin KH, Oxman MN (1999) Screening for depression in the older adult: Criterion validity of the 10-item center for epidemiological studies depression scale (CESD). Arch Intern Med 159(15):1701

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    Branch LG, Katz S, Kniepmann K, Papsidero JA (1984) A prospective study of functional status among community elders. Am J Public Health 74(3):266

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Diggle PJ, Heagerty P, Liang KY, Zeger SL (2002) Analysis of longitudinal data. Oxford; New York: Oxford University Press. 379 p

    Google Scholar 

  37. 37.

    Allison PD, SAS Institute (1999) Logistic regression using the SAS system: Theory and application. Cary, N.C.: SAS Institute

    Google Scholar 

  38. 38.

    SAS Institute (2008) SAS/STAT® user’s guide. (version 9.2). Cary, NC: SAS Institute

    Google Scholar 

  39. 39.

    Muñoz M, Fíto M, Marrugat J, Covas M, Schröder H (2009) Adherence to the Mediterranean diet is associated with better mental and physical health. Br J Nutr 101(12):1821–1827

    PubMed  Article  Google Scholar 

  40. 40.

    Bruinsma KA, Taren DL (2000) Dieting, essential fatty acid intake, and depression. Nutr Rev 58(4):98–108

    PubMed  Article  CAS  Google Scholar 

  41. 41.

    Delgado PL (2000) Depression: The case for a monoamine deficiency. J Clin Psychiatry 61Suppl 6:7–11

    PubMed  CAS  Google Scholar 

  42. 42.

    Skarupski K, Tangney C, Li H, Ouyang B, Evans D, et al (2010) Longitudinal association of vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time. Am J Clin Nutr 92(2):330–335

    PubMed  Article  CAS  Google Scholar 

  43. 43.

    Tolmunen T, Hintikka J, Ruusunen A, Voutilainen S, Tanskanen A, et al (2004) Dietary folate and the risk of depression in Finnish middle-aged men. A prospective follow-up study. Psychother Psychosom 73(6):334

    PubMed  Article  Google Scholar 

  44. 44.

    Kim J, Stewart R, Kim S, Yang S, Shin I, et al (2008) Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression. Brit J Psychiat 192(4):268

    PubMed  Article  Google Scholar 

  45. 45.

    Selhub J, Bagley LC, Miller J, Rosenberg IH (2000) B vitamins, homocysteine, and neurocognitive function in the elderly. Am J Clin Nutr 71(2):614S–620S

    PubMed  CAS  Google Scholar 

  46. 46.

    Sarandol A, Sarandol E, Eker SS, Erdinc S, Vatansever E, et al (2007) Major depressive disorder is accompanied with oxidative stress: Short-term antidepressant treatment does not alter oxidative-antioxidative systems. Hum Psychopharm 22(2):67–73

    Article  CAS  Google Scholar 

  47. 47.

    Barbizan R, Oliveira A (2010) Impact of acute inflammation on spinal motoneuron synaptic plasticity following ventral root avulsion. J Neuroinflammation 7:29–29

    PubMed  Article  Google Scholar 

  48. 48.

    Delion S, Chalon S, Guilloteau D, Besnard JC, Durand G (1996) Alpha-linolenic acid dietary deficiency alters age-related changes of dopaminergic and serotoninergic neurotransmission in the rat frontal cortex. J Neurochem 66(4):1582–1591

    PubMed  Article  CAS  Google Scholar 

  49. 49.

    Lin P, Su K (2007) A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. J Clin Psychiatry 68(7):1056–1061

    PubMed  Article  CAS  Google Scholar 

  50. 50.

    Guo S, Kim W, Lok J, Lee S, Besancon E, et al (2008) Neuroprotection via matrix-trophic coupling between cerebral endothelial cells and neurons. Proc Natl Acad Sci U S A 105(21):7582–7587

    PubMed  Article  CAS  Google Scholar 

  51. 51.

    Sánchez-Villegas A, Galbete C, Martinez-González M, Martinez JA, Razquin C, et al (2011) The effect of the Mediterranean diet on plasma brain-derived neurotrophic factor (BDNF) levels: The PREDIMED-NAVARRA randomized trial. Nutr Neurosci 14(5):195–201

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Kimberly A. Skarupski.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Skarupski, K.A., Tangney, C.C., Li, H. et al. Mediterranean diet and depressive symptoms among older adults over time. J Nutr Health Aging 17, 441–445 (2013). https://doi.org/10.1007/s12603-012-0437-x

Download citation

Key words

  • Diet
  • mediterranean dietary pattern
  • depressive symptoms
  • older adults