Structural Equation Modeling of the Relationships Between Pesticide Poisoning,Depressive Symptoms and Safety Behaviors Among Colorado Farm Residents

Abstract

Purpose: To use structural equation modeling (SEM) to test the theory that a past pesticide poisoning may act as a mediator in the relationship between depression and safety practices. Depression has been associated with pesticide poisoning and was more strongly associated with safety behaviors than workload, social support or health status of farm residents in a previously published report.

Methods: A cross-sectional survey of farmers and their spouses was conducted in eight counties in northeastern Colorado. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale. Exploratory and confirmatory factor analyses were used to identify symptoms most correlated with risk factors for depression and safety practices. SEM was used to examine theoretical causal models of the relationship between depression and poor health, financial difficulties, a history of pesticide poisoning, and safety practices.

Results: Exploratory factor analysis identified three factors in the CES-D scale. The SEM showed that poor health, financial difficulties and a history of pesticide poisoning significantly explained the depressive symptoms. Models with an excellent fit for the safety behaviors resulted when modeling the probability that the pesticide poisoning preceded depression, but no fit was possible when reversing the direction and modeling depression preceding pesticide poisoning.

Conclusions: Specific depressive symptoms appeared to be significantly associated with pri marily animal handling and farm machinery. The order of events, based on SEM results, was a pesti cide poisoning preceding depressed mood in relation to safety behaviors.     

Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults

BackgroundPrevious research on the Center for Epidemiologic Studies Depression Scale (CES-D) has five main limitations. First, no study provided evidence of the factorial equivalence of this instrument across samples of depressive and community participants. Second, only one study included systematic tests of measurement invariance based on confirmatory factor analyses (CFA), and this study did not consider the higher-order factor structure of depression, although it is the CES-D global scale score that is most often used in the context of epidemiological studies. Third, few studies investigated the screening properties of the CES-D in non-English-language samples and their results were inconsistent. Fourth, although the French version of the CES-D has been used in several previous studies, it has never been systematically validated among community and/or depressed adults. Finally, very few studies have taken into account the ordered-categorical nature of the CES-D answer scale. The purpose of the study reported herein was therefore to examine the construct validity (i.e., factorial, reliability, measurement invariance, latent mean invariance, convergence, and screening properties) of the CES-D in a French sample of depressed patients and community adults.MethodsA total sample of 469 participants, comprising 163 clinically depressed patients and 306 community adults, was involved in this study. The factorial validity, and the measurement and latent mean invariance of the CES-D across gender and clinical status, were verified through CFAs based on ordered-categorical items. Correlation and receiver operator characteristic curves were also used to test the convergent validity and screening properties of the CES-D.ResultsThe present results: (i) provided support for the factor validity and reliability of a second-order measurement model of depression based on responses to the CES-D items; (ii) revealed the full measurement invariance of the first- and second-order measurement models across gender; (iii) showed the partial strict measurement invariance (four uniquenesses had to be freely estimated, but the factor variance–covariance matrix also proved fully invariant) of the first-order factor model and the complete measurement invariance of the second-order model across patients and community adults; (iv) revealed a lack of latent mean invariance across gender and across clinical and community subsamples (with women and patients reporting higher scores on all subscales and on the full scale); (v) confirmed the convergent validity of the CES-D with measures of depression, self-esteem, anxiety, and hopelessness; and (vi) demonstrated the efficacy of the screening properties of this instrument among clinical and nonclinical adults.ConclusionThis instrument may be useful for assessing depressive symptoms or for the screening of depressive disorders in the context of epidemiological studies targeting French patients and community men and women with a background similar to those from the present study.     

Problems with the Japanese version of the Center for Epidemiologic Studies Depression (CES-D) scale when applied to Japanese independent community-dwelling elderly: an examination of the factor structure

Purpose The present study aimed to determine the problems of the Japanese version of the Center for Epidemiologic Studies Depression (CES-D) scale when applied to Japanese independent community-dwelling elderly focusing on its factor structure. Methods The subjects were 1791 community-dwelling independent elderly aged 60 and over (848 males and 943 females). This study used the Japanese version of the CES-D scale to assess depression in the elderly. Results From the results of an exploratory factor analysis, the four factors of somatic symptoms, depression affect, positive affect and relation with others were interpreted.These factors were the same as those in the previous study, but the items making up each subscale differed. Therefore, the construct validity of each subscale was not necessarily assured. In the confirmatory factor analysis, goodness-offit was high for both the first and second-order factor models. In examining the validity by Akaike’s information criterion (AIC), the second-order factor model assuming depression as a higher-order factor among the four factors was a better fit than the first-order factor model. Although the reliability of each subscale was not sufficient, adequate reliability was assured in the total scale. Conclusion An assessment of depression using the Japanese version of the CES-D scale should be conducted using the total score, while a re-examination of items making up each subscale is needed.     

Depression and Risk Factors Among Iowa Farmers

SUMMARY

Previous studies have reported high rates of depression and suicide for farmers compared to other occupations. From a representative sample of 390 Iowa farmers in the Iowa Farm Family Health and Hazard Survey, we found that 12.1? of Iowa principal farm operators had depressive symptoms based on a cut-off point of 16 on a standardized questionnaire for depressive symptoms (the CES-D Scale). A weighted multiple logistic regression model yielded the following risk factors for depressive symptoms: had legal problems (adjusted odds ratio = 7.35, 95? confidence interval = 3.09-17.48); not married (3.89, 1.10-13.73); sentimental value loss (2.96, 1.03-8.54);substantial income decline (2.91, 1.67-5.06); and decline in general health assessment compared with the excellent health group [very good and good group (3.39, 0.82-14.06) and fair and poor group (5.41, 1.89-15.43)].     

The Latent Symptom Structure of the Beck Depression Inventory: Second Edition in Latina Pregnant Women

Pregnancy represents a unique period of time when women are at an increased risk of developing depression. Although the Beck Depression Inventory-Second Edition (BDI-II) is one of the most widely used self-report measures of depression symptomology, its psychometric properties and underlying factor structures have not been determined for antenatal women and among Latinas. The current study evaluated the latent symptom structure of the BDI-II in a community-based sample of Latina pregnant women (N = 217) identified to be at high risk for depression. Exploratory factor analyses were used to identify underlying salient individual item loadings for two- and three-factor models. Confirmatory factor analyses then examined several different indices to determine the best model fit. Examination of exploratory and confirmatory factor analyses supports a three-factor oblique structure of the BDI-II composed of Cognitive–Affective, Somatic, and Pregnancy Symptoms. The three-factor model provides clinicians with the ability to target specific constellations of depressive symptoms instead of relying on the BDI-II total score that represents the overall severity of depression in this population.     

Associations between physical activity,television viewing and postnatal depressive symptoms amongst healthy primiparous mothers

BackgroundPostnatal depression is a serious illness in new mothers. In the general population, physical activity (PA) has been found to reduce the risk of depression, whilst sedentary behaviour (SB; in particular television viewing) has been linked to higher levels of depressive symptoms, yet little is known regarding associations between PA, SB and postnatal depression. This study aimed to investigate associations between PA, television viewing and postnatal depressive symptoms in healthy primiparous mothers..MethodsCross-sectional survey data were provided by 406 first-time mothers (approximately 3-months postpartum) enrolled in the Melbourne InFANT Extend trial (2012/2013). Women self-reported PA (time spent walking for leisure and transport, and other moderate and vigorous PA), television viewing, and depressive symptoms (CES-D 10). Random intercept linear models examined associations between PA, television viewing and depressive symptoms.ResultsIn crude models total PA was inversely associated with risk of postnatal depressive symptoms (B = −0.122; 95% CI = −0.24, -0.01). In models adjusted for key sociodemographic and behavioural covariates the association did not remain statistically significant. No other associations between PA, television viewing and postnatal depressive symptoms were evident..ConclusionsPostnatal depressive symptoms may not be related to PA and television viewing in the same way that these behaviours predict depressive symptoms in the general population. Further investigation of the specific domains of PA, as well as different types/contexts of SB and their respective associations with postnatal depressive symptoms is warranted in order to better inform development of targeted interventions aimed at enhancing postnatal mental health..     

Vitamin B6 Is Associated with Depressive Symptomatology in Massachusetts Elders

Objective: We examined the cross-sectional relationship between dietary vitamin B₆ and plasma pyridoxyl-5′-phosphate concentrations (PLP) with depressive symptomatology among a representative sample of 618 elderly Caribbean Hispanics, and a neighborhood based comparison group of 251 non-Hispanic white (NHW) older adults in Massachusetts.

Methods: Depressive symptomatology was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). 41% of Hispanics and 22.6% of NHWs had CES-D scores greater than 16, indicating depressive caseness. Dietary intake was calculated from a semi-quantitative food frequency questionnaire (FFQ) designed for this population.

Results: PLP was significantly associated with CES-D score and depressive caseness in the total sample and in non-supplement users. Deficient levels of plasma PLP (plasma PLP < 20 nmol/L) approximately doubled the likelihood of depressive caseness. Total intake (diet + supplement) of vitamin B₆ was not associated with these outcomes. However, dietary vitamin B₆ was significantly associated with CES-D score and depressive caseness.

Conclusion: Longitudinal studies are needed to clarify the direction of causality between vitamin B₆ and depressive symptoms.     

Violencia de pareja y depresión en mujeres que trabajan en una institución de salud de México

ObjectiveTo assess the effect of intimate partner violence on the risk of depression and depressive symptoms among adult women.MethodWe analyzed data from the Mexican Health Workers’ Cohort study (n = 470). Type and severity of intimate partner violence was ascertained between 2004 and 2011. Self-reported medical diagnosis of depression (2011) was the main outcome; depressive symptoms ascertained with the Centre for Epidemiologic Studies-Depression (CES-D) scale was the secondary outcome. Random-effects regressions were run to model the risk of depression (logistic) and depressive symptoms (linear) in relation to intimate partner violence.Results41.9% women experienced intimate partner violence at baseline. The incidence of depression was 7.2%. The risk of depression increased with any type of IPV (adjusted odds ratio [aOR] = 2.9; 95% confidence interval [95%CI]: 1.4–6.2) and with physical (aOR = 4.3; 95%CI: 1.8–10.1), psychological (aOR = 3.1; 95%CI: 1.4–6.6) and sexual (aOR = 3.1; 95%CI: 1.2–8.2) violence. Depressive symptoms (CES-D) increased slightly with physical and sexual intimate partner violence.ConclusionsIntimate partner violence was associated with a higher risk of depression in this sample of women working in a Mexican health facility. Our results indicate the need to develop infrastructure, to implement strategies of attention and counselling, and to provide a safe environment in the workplace for women who experience intimate partner violence.     

Depressive symptoms and their relationship with endogenous reproductive hormones and sporadic anovulation in premenopausal women

PurposeTo determine whether depressive symptoms are associated with ovulation or reproductive hormone concentrations in eumenorrheic women without a reported diagnosis of clinical depression.MethodsA prospective cohort of 248 regularly menstruating women, aged 18 to 44 years (27.3 ± 8.2) were evaluated for depressive symptoms at baseline using the 20-item Center for Epidemiological Studies Depression (CES-D) scale and categorized dichotomously (<16, no depressive symptoms [92%] vs. ≥16, depressive symptoms [8%]). Serum concentrations of estradiol, progesterone, luteinizing hormone, and follicle-stimulating hormone were measured up to eight times per cycle for up to two menstrual cycles. Linear mixed models estimated associations between depressive symptoms and hormone concentrations, whereas generalized linear mixed models assessed their relationship with sporadic anovulation.ResultsNo significant associations were identified between depressive symptoms and reproductive hormone levels (all P > .05) or the odds of sporadic anovulation (adjusted odds ratio, 1.1; 95% confidence interval, [0.02–5.0]), after adjusting for age, race, body mass index, perceived stress level, and alcohol consumption.ConclusionsDespite reported associations between mental health and menstrual cycle dysfunction, depressive symptoms were not associated with reproductive hormone concentrations or sporadic anovulation in this cohort of regularly menstruating women with no recent (within 1 year) self-reported history of clinical depression.     

Depressive Symptoms Among Older Adults Pre– and Post–COVID-19 Pandemic

ObjectivesIt is a concern that public health measures to prevent older people contracting COVID-19 could lead to a rise in mental health problems such as depression.The aim of this study therefore is to examine trends of depressive symptoms before and during the COVID-19 pandemic in a large cohort of older people.DesignObservational study with 6-year follow-up.Setting & ParticipantsMore than 3000 community-dwelling adults aged ≥60 years participating in The Irish Longitudinal Study on Ageing (TILDA).MethodsMixed effects multilevel models were used to describe trends in depressive symptoms across 3 waves of TILDA: wave 4 (2016), wave 5 (2018), and a final wave conducted July-November 2020. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale (CES-D), with a score ≥9 indicating clinically significant symptoms.ResultsThe prevalence of clinically significant depressive symptoms at waves 4 and 5 was 7.2% [95% confidence interval (CI) 6.5, 7.9] and 7.2% (95% CI 6.5, 8.0), respectively. This more than doubled to 19.8% (95% CI 18.5, 21.2) during the COVID-19 pandemic. There was no change in CES-D scores between waves 4 and 5 (β = 0.09, 95% CI –0.04, 0.23), but a large increase in symptoms was observed during the pandemic (β = 2.20, 95% CI 2.07, 2.33). Age ≥70 years was independently associated with depressive symptoms (β = 0.45, 95% CI 0.18, 0.72) during the pandemic but not from wave 4 to 5 (β = 0.09, 95% CI –0.18, 0.36). Living with others was associated with a lower burden of symptoms during the pandemic (β = −0.40, 95% CI –0.71, −0.09) but not between waves 4 and 5 (β = −0.40, 95% CI –0.71, −0.09).Conclusions and ImplicationsThis study demonstrates significant increases in the burden of depressive symptoms among older people during the COVID-19 pandemic, particularly those aged ≥70 years and/or living alone. Even a small increase in the incidence of late life depression can have major implications for health care systems and societies in general. Improving access to age-attuned mental health care should therefore be a priority.     

Development and Validation of a Diabetes Questionnaire for Middle School Students

ObjectiveTo develop and validate a questionnaire to assess diabetes knowledge, attitudes, beliefs, and intent to change among middle school students.DesignA cross-sectional validation analysis.SettingStudents in 3 urban middle schools in Utah participated in this study.ParticipantsThe 25-item questionnaire was validated in independent samples of 277 and 304 students in the seventh and eighth grades.Variables MeasuredThe questionnaire includes the following variables: diabetes knowledge, attitudes, beliefs, and intent to change dietary and physical activity behaviors.AnalysisRigorous statistical approaches, including Cronbach's α (goodness of fit) calculation, test-retest reliability, and exploratory and confirmatory factor analyses, were employed to examine the reliability and construct validity.ResultsThe Cronbach's α coefficients were 0.7 for both subscales demonstrating acceptable internal consistency. All factor loadings were > 0.4, revealing close relations between factors and items. The confirmatory factor analysis model fit was 0.9 for the comparative fit index and Tucker-Lewis Index, indicating a reasonable model-data fit.Conclusions and ImplicationsThis study demonstrated the validity of a diabetes questionnaire for middle school students. Future work is needed to validate its use in a diabetes prevention program, given the growing need for diabetes education among young adolescents.     

The German W-DEQ version B—Factor structure and prediction of posttraumatic stress symptoms six weeks and one year after childbirth

Abstract

The Wijma Delivery Expectancy/Experience Questionnaire is a frequently used measure in the context of childbirth. There are two versions with identical items for use during pregnancy (version A, fear of childbirth) and postpartum (version B, subjective experience) respectively. The original authors report that the measure is unidimensional, but since, very different factor structures have been found with different language versions. In this study, I tested the previously found factor structures in a sample of 338 German new mothers with confirmatory factor analysis. As none showed an adequate fit, I conducted an exploratory factor analysis, which yielded six factors with satisfactory internal consistencies.     

Factor analysis techniques for assessing sufficient unidimensionality of cancer related fatigue

Background: Fatigue is the most common unrelieved symptom experienced by people with cancer. The purpose of this study was to examine whether cancer-related fatigue (CRF) can be summarized using a single score, that is, whether CRF is sufficiently unidimensional for measurement approaches that require or assume unidimensionality. We evaluated this question using factor analysis techniques including the theory-driven bi-factor model. Methods: Five hundred and fifty five cancer patients from the Chicago metropolitan area completed a 72-item fatigue item bank, covering a range of fatigue-related concerns including intensity, frequency and interference with physical, mental, and social activities. Dimensionality was assessed using exploratory and confirmatory factor analysis (CFA) techniques. Results: Exploratory factor analysis (EFA) techniques identified from 1 to 17 factors. The bi-factor model suggested that CRF was sufficiently unidimensional. Conclusions: CRF can be considered sufficiently unidimensional for applications that require unidimensionality. One such application, item response theory (IRT), will facilitate the development of short-form and computer-adaptive testing. This may further enable practical and accurate clinical assessment of CRF. An erratum to this article can be found at     

Alcohol misuse,depressive symptoms,and HIV/STI risks of US Hispanic women

Objectives: Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study’s objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors.

Design: Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors.

Results: Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR?=?2.15) and better HIV/STI knowledge (β?=??.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR?=?1.76) and worse HIV/STI knowledge (β?=?.37).

Conclusions: Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women’s health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women.     

Working conditions,psychosocial environmental factors,and depressive symptoms among wage workers in South Korea

Background: In South Korea, the number of workers suffering from mental illnesses, such as depression, has rapidly increased. There is growing concern about depressive symptoms being associated with both working conditions and psychosocial environmental factors.

Objectives: To investigate potential psychosocial environmental moderators in the relationship between working conditions and occupational depressive symptoms among wage workers.

Methods: Data were obtained from the wage worker respondents (n = 4,095) of the Korean National Health and Nutrition Examination Survey of 2009. First, chi-square tests confirmed the differences in working conditions and psychosocial characteristics between depressive and non-depressive groups. Second, multivariate logistic regression analysis was performed to examine the moderating effects of the psychosocial environmental factors between working conditions and depressive symptoms.

Results: After adjusting for potential covariates, the likelihood of depressive symptomatology was high among respondents who had dangerous jobs and flexible work hours compared to those who had standard jobs and fixed daytime work hours (OR = 1.66 and 1.59, respectively). Regarding psychosocial factors, respondents with high job demands, low job control, and low social support were more likely to have depressive symptoms (OR = 1.26, 1.58 and 1.61, respectively).

Conclusions: There is a need to develop non-occupational intervention programs, which provide workers with training about workplace depression and improve social support, and the programs should provide time for employees to have active communication. Additionally, companies should provide employees with support to access mental healthcare thereby decreasing the occurrence of workplace depression.     

Polyunsaturated fatty acids levels and initial presentation of somatic symptoms induced by interferon-alpha therapy in patients with chronic hepatitis C viral infection

Objectives: Somatic symptoms are common in depressive disorder and are similar to sickness behaviors due to inflammatory activation after cytokine administration. Omega-3 polyunsaturated fatty acids (PUFAs) are natural anti-inflammatory agents and may reduce inflammation-induced behavioral changes. The aim of this study was to investigate the role of PUFAs on the development of somatic symptoms and depression in patients of hepatitis C virus infection (HCV) receiving interferon-alpha therapy (IFN-α) in a prospective manner.

Methods: In this 24-week, prospective cohort study, 43 patients with chronic HCV ongoing IFN-α therapy were assessed with the mini-international neuropsychiatric interview for major depressive episodes and neurotoxicity rating scale (NRS) for somatic symptoms.

Results: One-third later developed IFN-α-induced depression (depression (DEP) group). As compared to subjects without depression, DEP group had higher NRS scores (P?P?=?0.038) at week 2. Somatic symptoms, regardless of painful/non-painful characteristics, had positive association with arachidonic acid (P?P?Conclusion: This study implies that early intervention with omega-3 PUFAs might be a promising strategy to prevent depression and somatic symptoms in patients receiving cytokine therapy.     

Inflammation and the Association of Vitamin D and Depressive Symptomatology

Depression and vitamin D deficiency are major public health problems. The existing literature indicates the complex relationship between depression and vitamin D. The purpose of this study was to examine whether this relationship is moderated or mediated by inflammation. A community sample (n = 7162) from the LIFE-Adult-Study was investigated, for whom depressive symptoms were assessed via the German version of CES-D scale and serum 25-hydroxyvitamin D (25(OH)D) levels and inflammatory markers (IL-6 and CRP levels, WBC count) were quantified. Mediation analyses were performed using Hayes’ PROCESS macro and regression analyses were conducted to test moderation effects. There was a significant negative correlation between CES-D and 25(OH)D, and positive associations between inflammatory markers and CES-D scores. Only WBC partially mediated the association between 25(OH)D levels and depressive symptoms both in a simple mediation model (ab: −0.0042) and a model including covariates (ab: −0.0011). None of the inflammatory markers showed a moderation effect on the association between 25(OH)D levels and depressive symptoms. This present work highlighted the complex relationship between vitamin D, depressive symptoms and inflammation. Future studies are needed to examine the effect of vitamin D supplementation on inflammation and depressive symptomatology for causality assessment.     

The Impact of Symptoms of Depression and Walking on Gestational Age at Birth in African American Women

BackgroundSymptoms of depression have been related to lower gestational age and preterm birth (<37 completed weeks gestation). Leisure time physical activity may have protective effects on preterm birth; however, less has been published with regard to other domains of physical activity such as walking for a purpose (e.g., for transportation) or the pathways by which symptoms of depression impact gestational age at birth.MethodsThis was a secondary analysis of available data of African American women. Women were interviewed within 3 days after birth. We proposed a model in which walking for a purpose during pregnancy mediated the effects of symptoms of depression (measured by the 20-item Center for Epidemiologic Studies-Depression [CES-D] scale) on gestational age at birth in a sample of 1,382 African American women.ResultsUsing structural equation modeling, we found that the direct effect of CES-D scores of 23 or greater, which have been correlated with major depression diagnosis, on gestational age at birth was -4.23 (p < .001). These results indicate that symptoms of depression were associated with a decrease in gestational age at birth of 4.23 days. Walking for a purpose mediated the effect of CES-D scores of 23 or greater on gestational age at birth.ConclusionsCompared with African American women without symptoms of depression, African American women who had symptoms of depression walked less for a purpose during their pregnancy and delivered infants with lower gestational age at birth. If not medically contraindicated, clinicians should incorporate walking as part of prenatal care recommendations and reassure women about safety of walking during pregnancy.     

Vitamin B-6 and depressive symptomatology,over time,in older Latino adults

Background: Low vitamin B-6 status has been linked to depressive symptomatology. We examined the longitudinal association of vitamin B-6 status with depressive symptomatology across 3-time points over ～5–7 years in a cohort of older Hispanic adults.

Methods: We used two-level hierarchical linear regression models for continuous outcomes. Vitamin B-6 status was associated with depressive symptomatology across these time points.

Results: Plasma pyridoxyl-5-phosphate (PLP) concentration, a time-varying predictor, was significantly associated with depressive symptomatology. Study participants with PLP deficiency, vs. optimal PLP, had higher baseline depressive symptoms (Center for Epidemiologic Studies-Depression Scale (CES-D) score of 22?±?14, vs. 20?±?13); this differential remained constant over time and persisted after controlling for age, sex, education, body mass index, smoking and alcohol use, other relevant nutritional factors, perceived stress, stressful life events, allostatic load, and use of antidepressant medication. However, PLP concentration was not associated with the rate of change in depressive symptomatology over time.

Conclusions: Suboptimal plasma PLP is associated with higher depressive symptomatology in older Hispanic of Puerto Rican descent and this appears to persist over time. Our data suggest that identification and treatment of vitamin B-6 deficiency may be a useful preventive approach in this population.