Research projects

Beyond Ageing Follow Up Study: A randomised controlled trial of folic acid and vitamin B12, physical activity, mental health literacy for the indicated prevention of depression

Principal researchers

Professor Anthony Jorm2
Professor Helen Christensen1
Professor Ian Hickie3
Project Coordinator: Dr Janine Walker1
Survey Administrator: Ms Dimity Crisp1
Research Assistants: Ms Affrica McCarthy and Ms Amanda George1
PhD Candidate: Ms Affrica McCarthy1
Medical Advisor: Professor Marjan Kljakovic4
Ageing and Cognition Advisor: Professor Kaarin Anstey1
Mental Health Literacy Advisor: Professor Kathy Griffiths1
Folate and Vitamin B12 Advisor: Dr Michael Fenech5

Institution

1 Centre for Mental Health Research, Australian National University
2 Orygen
3 Brain and Mind Research Institute, University of Sydney
4 Academic Unit of General Practice and Community Health, Australian National University
5 CSIRO Division of Human Nutrition, Adelaide

Funding

$50,083

Award type

beyondblue grant

Project completion year

2011

Project brief

The Beyond Ageing Follow Up Study was funded by beyondblue to extend this important and groundbreaking research into the health and wellbeing of older Australians.

Aims and hypotheses

The Beyond Ageing Follow Up Study had five broad aims, which were implemented within a single large community-based randomised controlled trial (the data presented is for depression, mostly from baseline to 12-month assessment):

  • To test whether folic acid + vitamin B12 can prevent depression in older people
  • To test whether promoting physical activity can prevent depression in older people
  • To test whether improving mental health literacy can prevent depression in older people
  • To test whether folic acid + vitamin B12 can prevent cognitive impairment in older people
  • To test whether physical activity promotion can prevent cognitive impairment in older people.

Findings

The researchers identified three candidate interventions that may prove to be useful in prevention of depression in older people. Physical activity, both aerobic and progressive resistance training, is an effective treatment in mild to severe depression, with remission rates comparable to cognitive therapy or antidepressant medication. Mediated physical activity programs, where interventions are delivered entirely by the telephone, mail or online, may increase physical activity levels, suggesting a potential role for these non-intensive methods in large scale prevention interventions.

Mental health literacy has been found to reduce depression symptoms in a number of trials. There are indications from clinical and treatment studies that folate and vitamin B12 may reduce or prevent depression. Folic acid and vitamin B12 supplementation may prevent depression by lowering homocysteine (Hcy) levels, which are elevated in depressed patients and in some samples of older people. Low folate levels and vitamin B12 have been found in community samples of depressed adults, although the evidence is uncertain whether folate and vitamin B12 offer effective treatment for depression. Supplementary folic acid and vitamin B12 may also reduce the long-term risk to onset of depression via reduction of vascular and other metabolic risk factors to late life depression.

References

Journal articles

Jenkins A., Christensen, H., Walker, J.G., and Dear K.B.G. (In press) The Effectiveness of Distance Interventions for Increasing Physical Activity: A Review. American Journal of Health Promotion. Accepted 07/2008

Busby Grant, J.A., Mackinnon, A.J., Christensen, H., & Walker, J.G. (revision). Participants' perceptions of motivation, randomisation and withdrawal in a community-based prevention randomised controlled trial, Social Science & Medicine.

Walker, J.G., Mackinnon, A.J., Batterham, P., Jorm, A.F., Hickie, I., McCarthy, A., Fenech, M. & Christensen, H. (Submitted). The Beyond Ageing Project: A randomized controlled trial of folic acid and vitamin B12, physical activity, and mental health literacy for the indicated prevention of depression. JAMA.

Invited conference papers

Walker, J.G. (2005). Is physical activity and effective treatment for depression in older people? Mental Health in Primary Care Forum, 3rd November 2005, Perth. All expenses paid by the Australian Divisions of General Practice.

Walker, J.G. (2005). The Beyond Ageing Project. Challenging Depression in the Elderly, The Hammond Care Group, 23 - 24 June 2005, Sydney.

Walker, J.G. (2005). The links between mental health and physical health. 2nd International Conference on Healthy Ageing and Longevity, 18-20 March, Brisbane, Australia, 93. All expenses paid by the Australian Divisions of General Practice.

Walker, J.G., George, A.M., Windsor, T.D., Christensen, H. (2006). Risk factors for physical inactivity across the adult lifespan: The impact of depression. Proceedings of the Australasian Society for Psychiatric Research, 6 – 8 December, Sydney, Australia.

Jenkins, A., Christensen, H., Dear, K., & Walker, J. (2005). Effectiveness of distal interventions for encouraging physical activity. Proceedings of the Australasian Society for Psychiatric Research, 7 – 9 December, Perth, Australia.

Invited articles – non-refereed

Walker, J.G. (2006). Is physical activity an effective treatment for depression? PARC update. Primary Mental Health Care Australian Resource Centre: Adelaide, Australia; 16-17.

Walker, J.G. (2005). Practical ways for older people to prevent depression: The Beyond Ageing Project. Quest, 4, 12-15.

Manuals/handbooks

Tayler, G., Griffiths, K. & Christensen, H. (2007). Interpersonal psychotherapy: A “how to” guide for tackling relationships and improving well being. Centre for Mental Health Research: Canberra, Australia.

Banfield, M. & Griffiths, K. (2006). Sleep well: A “how to” guide for improving sleep. Centre for Mental Health Research: Canberra, Australia.

Christensen, H. & Tayler, G. (2006). What works for anxiety. Centre for Mental Health Research: Canberra, Australia.

Jenkins, A. & Walker, J.G. (2006). Structured problem solving training: Practical ways to manage depression. Centre for Mental Health Research: Canberra, Australia.

Frazer, C., Christensen, H., Griffiths, K., Walker J.G. & Jenkins A. (2005). Help for depression: What works for older people. Centre for Mental Health Research: Canberra, Australia.

Walker, J.G. & Jenkins, A. (2005). Over the hill: A handbook for making physical activity a part of your life. Centre for Mental Health Research: Canberra, Australia.

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