Vitamin D intake and mental health-related quality of life in older women: the Iowa Women's Health Study

Objective

Vitamin D deficiency and mood disorders are both prevalent among the elderly. We evaluated the association between vitamin D intake and mental health-related quality of life (QOL) among elderly women participating in a large population-based study.

Study design

This study was a cross-sectional analysis of the Iowa Women's Health Study, a prospective study of cancer risk factors among post-menopausal women in Iowa that began in 1986. Additional survey data was collected from the cohort members in 1987, 1989, 1992, 1997, and 2004. Data for this analysis came from the 2004 questionnaire.

Main outcome measure

Mental health-related QOL was assessed using five scales from the Medical Outcomes Study 36-item Short-form Health Survey. QOL scores were analyzed as continuous variables using linear regression, controlling for age, energy intake, BMI, education, smoking, living arrangement, antidepressant usage, comorbidity history, and physical activity.

Results

Low vitamin D intake (<400 IU/day) was associated with poorer QOL scores compared to women with higher intake (≥400 IU/day). Differences in QOL scores by vitamin D intake group were attenuated with multivariable adjustment, but a significant overall association between vitamin D and QOL scores persisted. Further adjustment for physical activity attenuated all differences as well as the overall association between vitamin D and QOL scores.

Conclusions

Women who consumed <400 IU/day of vitamin D had significantly lower mental health-related QOL compared to those who consumed ≥400 IU/day. Meeting dietary vitamin D recommendations is a potential method for improving QOL among the elderly.     

Cytokine balance and behavioral intervention; findings from the Peer Approaches to Lupus Self-Management (PALS) project

The Peer Approaches to Lupus Self-Management program sought to address the disparate impact of systemic lupus erythematosus (SLE) on African American women through a peer mentoring intervention with aims of reducing stress, anxiety, and depression. Given the association between psychological health and immune function this study examines the relationship between patient reported outcomes (PROs) in these domains and immunologic indicators of disease activity. Twenty-three African American women with SLE served as mentees in the intervention from whom PRO measures were collected at the outset, midpoint, and end of the 12 week pilot study. Blood samples were collected pre- and post-intervention. Plasma was collected from the samples and cryopreserved for subsequent analyses. The strongest correlations were between the Generalized Anxiety Disorder measure and Th1/Th2 cytokine balance. Weaker correlations existed between depression and the Th1/Th2 cytokine balance. Assessment of fresh versus cryopreserved samples revealed that changes in Th1/Th2 cytokine balance within the intervention were generally equivalent, regardless of sample type. The PALS intervention resulted in significant improvements to anxiety and depression levels which were significantly associated with positive changes in Th1/Th2 cytokine balance indicating a possible underlying mechanism of action. The nature of this relationship warrants further study.     

Impact in the quality of life of parents of children with chronic diseases using psychoeducational interventions – A systematic review with meta-analysis

ObjectiveThis study aimed to identify psychoeducational interventions applied to parents of children with chronic diseases and evaluate their impact on their quality of life (QoL).MethodsIt was conducted in six databases, complemented by references from the included studies and other reviews, manual search, and contact with experts. We included primary studies on parents of children with chronic diseases that studied psychoeducational interventions versus standard care.ResultsWe screened 6604 titles and abstracts, reviewed the full text of 60 records, and included 37 primary studies. Half of the studies were on Asthma. We found three intervention formats: one-to-one (43%), groups (49%), and combined approach with individual and group settings (8%). More than 60% of the included studies found statistically significant differences between the intervention and the control group (p < 0.05).ConclusionSeveral interventions have shown efficacy in improving parental QoL. Despite that, there is insufficient evidence of interventions' implementation.Practice implicationsA holistic approach encompassing the patient and the family's biopsychosocial dimensions is fundamental in successfully managing chronic disease in children. It is vital to design and implement interventions accommodating the common issues experienced by children, parents, and families that deal with chronic childhood conditions.Systematic review registration number PROSPERO 2018 CRD42018092135.