Plasma fatty acid composition and depression are associated in the elderly: The Rotterdam Study

Background: It has been hypothesized that n-3 polyunsaturated fatty acids (PUFAs) are involved in mood regulation, but epidemiologic evidence for such a link in the general population is lacking. Objective: This study examined whether community-dwelling elderly persons with depression have a fatty acid composition that is different from that of nondepressed persons. Design: We screened 3884 adults aged greater than or equal to60 y for depressive symptoms as part of the Rotterdam Study. Subjects who screened positive had a psychiatric interview to diagnose depressive disorders. All eligible subjects had their blood drawn for measurement of plasma phospholipid concentrations. We compared percentages of n-3 and n-6 PUFAs and their ratios between 264 subjects with depressive symptoms, including 106 subjects with depressive disorders, and 461 randomly selected reference subjects. We also investigated whether atherosclerosis or the inflammatory response as measured by C-reactive protein underlies the relation between fatty acid composition and depression. Results: Subjects with depressive disorders had a higher ratio of n-6 to n-3 PUFAs, but differences in individual PUFAs were mostly small. However, depressed subjects with normal CRP concentrations (< 1.5 mg/L) had a substantially altered fatty acid composition; percentages of n-3 PUFAs and ratios of n-6 to n-3 PUFAs were significantly lower and higher, respectively, in subjects with depressive disorders than in control subjects [5.2% compared with 5.9% (P = 0.02) and 7.2 compared with 6.6 (P = 0.01), respectively]. This relation was not due to atherosclerosis. Conclusions: In community-dwelling persons, fatty acid composition is related to depression. Because this relation was not secondary to inflammation, atherosclerosis, or possible confounders, it suggests a direct effect of fatty acid composition on mood.