human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Depression is common and the efficacy of antidepressants is suboptimal . High plasma homocysteine has been consistently associated with depression , and treatment with certain B vitamins demonstrably reduces its concentration . AIMS To determine whether vitamins B6 , B12 and folic acid enhance response to antidepressant treatment  over 52 weeks . METHOD R and omised , double-blind , placebo-controlled trial of citalopram ( 20 - 40 g ) together with 0.5 mg of vitamin B12 , 2 mg of folic acid and 25 mg of vitamin B6 for 52 weeks ( Australian and New Zeal and Clinical Trials Registry : 12609000256279 ) . Participants were community-dwelling adults aged 50 years or over with DSM-IV-TR major depression . We measured severity of symptoms with the Montgomery-Åsberg Depression Rating Scale ( MADRS ) . The primary outcome was remission of the depressive episode after 12 , 26 and 52 weeks . Secondary outcomes included reduction of MADRS scores over time and relapse of major depression after recovery by week 12 . Results In total , 153 people were r and omised ( 76 placebo , 77 vitamins ) .  Remission of symptoms was achieved by 78.1 and 79.4 % of participants treated with placebo and vitamins by week 12 ( P = 0.840 ) , by 76.5 and 85.3 % at week 26 and 75.8 and 85.5 % at week 52 ( effect of intervention over 52 weeks : odds ratio ( OR ) = 2.49 , 95 % CI 1.12 - 5.51 ) . Group differences in MADRS scores over time were not significant ( P = 0.739 ) . The risk of subsequent relapse among those who had achieved remission of symptoms at week 12 was lower in the vitamins than placebo group ( OR = 0.33 , 95 % CI 0.12 - 0.94 ) . CONCLUSIONS B vitamins did not increase the 12-week efficacy of antidepressant treatment , but enhanced and sustained antidepressant response over 1 year . Replication of these findings would m and ate that treatment guidelines adopt the adjunctive use of B vitamins as a safe and inexpensive strategy to manage major depression in middle-aged and older adults BACKGROUND B-vitamin deficiencies have been associated with depression ; however , there is very little prospect i ve evidence from population -based studies of older adults . OBJECTIVE We examined whether dietary intakes of vitamins B-6 , folate , or vitamin B-12 were predictive of depressive symptoms over an average of 7.2 y in a community-based population of older adults . DESIGN The study sample consisted of 3503 adults from the Chicago Health and Aging project , an ongoing , population -based , biracial ( 59 % African American ) study in adults aged > or = 65 y.  Dietary assessment was made by food-frequency question naire . Incident depression was measured by the presence of > or = 4 depressive symptoms from the 10-item version of the Center for Epidemiologic Studies Depression scale . RESULTS The logistic regression models , which used generalized estimating equations , showed that higher total intakes , which included supplementation , of vitamins B-6 and B-12 were associated with a decreased likelihood of incident depression for up to 12 y of follow-up , after adjustment for age , sex , race , education , income , and antidepressant medication use . For example , each 10 additional milligrams of vitamin B-6 and 10 additional micrograms of vitamin B-12 were associated with 2 % lower odds of depressive symptoms per year . There was no association between depressive symptoms and food intakes of these vitamins or folate . These associations remained after adjustment for smoking , alcohol use , widowhood , caregiving status , cognitive function , physical disability , and medical conditions . CONCLUSION Our results support the hypotheses that high total intakes of vitamins B-6 and B-12 are protective of depressive symptoms over time in community-residing older adults BACKGROUND The role of folate , vitamin B(12 ) and homocysteine levels in depression is not clear . AIMS To investigate cross-sectional and prospect i ve associations between folate , B(12 ) and homocysteine levels and late-life depression . METHOD A total of 732 Korean people aged 65 years or over were evaluated at baseline . Of the 631 persons who were not depressed , 521 ( 83 % ) were followed over a period of 2 - 3 years and incident depression was ascertained with the Geriatric Mental State schedule .  Serum folate , serum vitamin B(12 ) and plasma homocysteine levels were assayed at both baseline and follow-up . RESULTS Lower levels of folate and vitamin B(12 ) and higher homocysteine levels at baseline were associated with a higher risk of incident depression at follow-up . Incident depression was associated with a decline in vitamin B(12 ) and an increase in homocysteine levels over the follow-up period . CONCLUSIONS Lower folate , lower vitamin B(12 ) and raised homocysteine levels may be risk factors for late-life depression Objectives : 1 ) To compare serum vitamin B12 , C and folate concentrations in a r and omly selected sample of elderly ( age 65 years or older ) male and female Hispanics and nonHispanic whites ( NHW ) and 2 ) to examine associations between serum B12 , C and folate concentrations compared to measures of cognitive and affective ( depression ) functions . Methods : Equal numbers of male and female Hispanics and NHW were r and omly sample d from the Health Care Financing Administration ( Medicare ) registrant list for Bernalillo County , New Mexico , and asked to volunteer for a paid home interview followed by a paid comprehensive interview/examination covering health and health-related issues . In addition to serum determinations of B12 , C and folate , associations were examined between these vitamins and measures of cognitive and affective functions . Results : Males and Hispanics had lower serum vitamin B12 , C and folate concentrations than females and NHW respectively . Participants taking a multivitamin supplement ( MVI ) had higher serum vitamin concentrations than those not taking MVI . There were significant associations between serum folate concentrations and measures of cognitive function , not seen with B12 or C , nor between any of the vitamins and affective function . Conclusions : Hispanics , even after adjustments for gender , age , vitamin supplementation , vitamin content of dietary foods , education and household income , had lower serum concentrations of B12 , C and folate than NHW . The most significant associations observed were those between serum folate and various measures of cognitive function , even after adjusting for presence of depression OBJECTIVE The associations of vitamin B(12 ) , folate , and homocysteine with depression were examined in a population -based study . METHOD The authors screened 3,884 elderly people for depressive symptoms . Subjects with positive screening results had psychiatric workups .  Folate , vitamin B(12 ) , and homocysteine blood levels  were compared in 278 persons with depressive symptoms , including 112 with depressive disorders , and 416 r and omly selected reference subjects . Adjustments were made for age , gender , cardiovascular disease , and functional disability . RESULTS Hyperhomocysteinemia , vitamin B(12 ) deficiency , and to a lesser extent , folate deficiency were all related to depressive disorders . For folate deficiency and hyperhomocysteinemia , the association with depressive disorders was substantially reduced after adjustment for functional disability and cardiovascular disease , but for vitamin B(12 ) this appeared independent . CONCLUSIONS The association of vitamin B(12 ) and folate with depressive disorders may have different underlying mechanisms . Vitamin B(12 ) may be causally related to depression , whereas the relation with folate is due to physical comorbidity OBJECTIVE The authors conducted two multicenter sequential parallel comparison design trials to investigate the effect of L-methylfolate augmentation in the treatment of major depressive disorder in patients who had a partial response or no response to selective serotonin reuptake inhibitors ( SSRIs ) .  METHOD In the first trial , 148 out patients with SSRI-resistant major depressive disorder were enrolled in a 60-day study divided into two 30-day periods . Patients were r and omly assigned , in a 2:3:3 ratio , to receive L-methylfolate for 60 days ( 7.5 mg/day for 30 days followed by 15 mg/day for 30 days ) , placebo for 30 days followed by L-methylfolate ( 7.5 mg/day ) for 30 days , or placebo for 60 days . SSRI dosages were kept constant throughout the study . In the second trial , with 75 patients , the design was identical to the first , except that the l-methylfolate dosage was 15 mg/day during both 30-day periods . RESULTS In the first trial , no significant difference was observed in outcomes between the treatment groups . In the second trial , adjunctive L-methylfolate at 15 mg/day showed significantly greater efficacy compared with continued SSRI therapy plus placebo on both primary outcome measures ( response rate and degree of change in depression symptom score ) and two secondary outcome measures of symptom severity . The number needed to treat for response was approximately six in favor of adjunctive L-methylfolate at 15 mg/day . L-Methylfolate was well tolerated , with rates of adverse events no different from those reported with placebo . CONCLUSIONS Adjunctive L-methylfolate at 15 mg/day may constitute an effective , safe , and relatively well tolerated treatment strategy for patients with major depressive disorder who have a partial response or no response to SSRIs Depressed geriatric patients have lower levels of folate ( FOL ) than controls . Also , FOL supplement can reduce depressive morbidity . One hypothesis consistent with this is that FOL deficiency causes a lowering of CNS serotonin that contributes to depression . The present report is from one site of a multicenter study that compared an SSRI ( sertraline ) with a nonspecific tricyclic antidepressant ( nortriptyline ) in geriatric depressed patients . We added measures of FOL at baseline and outcome for 22 depressed patients older than 60 years . Both treatments were effective . At baseline , FOL levels were within the normal range . Higher FOL levels at baseline predicted greater improvement . Further study of FOL interaction with SSRI is warranted . For the group treated with the SSRI , baseline FOL level was a more efficient predictor of improvement , especially for results on a self-rating depression scale ( POMS ) Tetrahydrobiopterin is a cofactor in the synthesis of monoamine neurotransmitters . High neopterin levels generally signal increased immune activation . Both pterins have been investigated in several small clinical studies of depressed patients with conflicting results . Therefore , we examined the relation of plasma biopterin and neopterin with depression in a population -based study . We also studied the association of pterins with folates in depressed persons as this vitamin is required for pterin bio synthesis . We screened 3884 adults aged 60 years and over for depressive symptoms . Screen positive subjects had a psychiatric interview to diagnose DSM-IV disorder .  Plasma pterins and serum folate  were determined in all persons with depressive symptoms ( n=238 ) and r and omly selected non-depressed persons ( n=357 ) . We found no association between the concentration of biopterin or neopterin with depressive symptoms or depressive disorders . However , in depressed persons the relation between pterins and folates was different than in the non-depressed , i.e. neopterin concentrations increased with folate levels in persons with depressive symptoms ( 0.09 per log(nmol/l folate ) ; 95 % CI=0.01 , 0.18 , P=0.03 ) , but not in non-depressed persons ( -0.07 per log(nmol/l folate ) ; 95 % CI=-0.17 , 0.03 , P=0.18 ) . The interaction between depressive symptoms , folate and neopterin was significant ( P=0.03 ) . The study suggests that the relation between folate and pterins is altered in the depressed elderly 5-methyltetrahydrofolate ( MTHF ) is a naturally occurring substance involved in the synthesis of s-adenosyl-l-methionine ( SAMe ) , a major source of methyl groups in the brain . To assess the efficacy of a gastro-resistant , oral preparation of MTHF , 20 elderly patients with a DSM-III-R diagnosis of depressive disorder and a HAM-D-21 score > or = 18 underwent 6-weeks of open-label treatment with 50 mg per day of oral MTHF . Of these 20 patients , 16 completed at least 4 weeks of treatment and showed a markedly significant improvement in their depressive symptoms at endpoint , with 81 % of them being considered responders . There were no clinical ly relevant changes in the routine laboratory tests during the study , and no adverse events considered to be definitely drug-related were reported This was a 4-week r and omized placebo-controlled double-blind study to assess augmentation of open tricyclic 
    Output:
    
agent
Conclusion : Low folate and B12 serum levels seem to be associated with  depression in the aged .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Depression is common and the efficacy of antidepressants is suboptimal . High plasma homocysteine has been consistently associated with depression , and treatment with certain B vitamins demonstrably reduces its concentration . AIMS To determine whether vitamins B6 , B12 and folic acid enhance response to antidepressant treatment  over 52 weeks . METHOD R and omised , double-blind , placebo-controlled trial of citalopram ( 20 - 40 g ) together with 0.5 mg of vitamin B12 , 2 mg of folic acid and 25 mg of vitamin B6 for 52 weeks ( Australian and New Zeal and Clinical Trials Registry : 12609000256279 ) . Participants were community-dwelling adults aged 50 years or over with DSM-IV-TR major depression . We measured severity of symptoms with the Montgomery-Åsberg Depression Rating Scale ( MADRS ) . The primary outcome was remission of the depressive episode after 12 , 26 and 52 weeks . Secondary outcomes included reduction of MADRS scores over time and relapse of major depression after recovery by week 12 . Results In total , 153 people were r and omised ( 76 placebo , 77 vitamins ) .  Remission of symptoms was achieved by 78.1 and 79.4 % of participants treated with placebo and vitamins by week 12 ( P = 0.840 ) , by 76.5 and 85.3 % at week 26 and 75.8 and 85.5 % at week 52 ( effect of intervention over 52 weeks : odds ratio ( OR ) = 2.49 , 95 % CI 1.12 - 5.51 ) . Group differences in MADRS scores over time were not significant ( P = 0.739 ) . The risk of subsequent relapse among those who had achieved remission of symptoms at week 12 was lower in the vitamins than placebo group ( OR = 0.33 , 95 % CI 0.12 - 0.94 ) . CONCLUSIONS B vitamins did not increase the 12-week efficacy of antidepressant treatment , but enhanced and sustained antidepressant response over 1 year . Replication of these findings would m and ate that treatment guidelines adopt the adjunctive use of B vitamins as a safe and inexpensive strategy to manage major depression in middle-aged and older adults BACKGROUND B-vitamin deficiencies have been associated with depression ; however , there is very little prospect i ve evidence from population -based studies of older adults . OBJECTIVE We examined whether dietary intakes of vitamins B-6 , folate , or vitamin B-12 were predictive of depressive symptoms over an average of 7.2 y in a community-based population of older adults . DESIGN The study sample consisted of 3503 adults from the Chicago Health and Aging project , an ongoing , population -based , biracial ( 59 % African American ) study in adults aged > or = 65 y.  Dietary assessment was made by food-frequency question naire . Incident depression was measured by the presence of > or = 4 depressive symptoms from the 10-item version of the Center for Epidemiologic Studies Depression scale . RESULTS The logistic regression models , which used generalized estimating equations , showed that higher total intakes , which included supplementation , of vitamins B-6 and B-12 were associated with a decreased likelihood of incident depression for up to 12 y of follow-up , after adjustment for age , sex , race , education , income , and antidepressant medication use . For example , each 10 additional milligrams of vitamin B-6 and 10 additional micrograms of vitamin B-12 were associated with 2 % lower odds of depressive symptoms per year . There was no association between depressive symptoms and food intakes of these vitamins or folate . These associations remained after adjustment for smoking , alcohol use , widowhood , caregiving status , cognitive function , physical disability , and medical conditions . CONCLUSION Our results support the hypotheses that high total intakes of vitamins B-6 and B-12 are protective of depressive symptoms over time in community-residing older adults BACKGROUND The role of folate , vitamin B(12 ) and homocysteine levels in depression is not clear . AIMS To investigate cross-sectional and prospect i ve associations between folate , B(12 ) and homocysteine levels and late-life depression . METHOD A total of 732 Korean people aged 65 years or over were evaluated at baseline . Of the 631 persons who were not depressed , 521 ( 83 % ) were followed over a period of 2 - 3 years and incident depression was ascertained with the Geriatric Mental State schedule .  Serum folate , serum vitamin B(12 ) and plasma homocysteine levels were assayed at both baseline and follow-up . RESULTS Lower levels of folate and vitamin B(12 ) and higher homocysteine levels at baseline were associated with a higher risk of incident depression at follow-up . Incident depression was associated with a decline in vitamin B(12 ) and an increase in homocysteine levels over the follow-up period . CONCLUSIONS Lower folate , lower vitamin B(12 ) and raised homocysteine levels may be risk factors for late-life depression Objectives : 1 ) To compare serum vitamin B12 , C and folate concentrations in a r and omly selected sample of elderly ( age 65 years or older ) male and female Hispanics and nonHispanic whites ( NHW ) and 2 ) to examine associations between serum B12 , C and folate concentrations compared to measures of cognitive and affective ( depression ) functions . Methods : Equal numbers of male and female Hispanics and NHW were r and omly sample d from the Health Care Financing Administration ( Medicare ) registrant list for Bernalillo County , New Mexico , and asked to volunteer for a paid home interview followed by a paid comprehensive interview/examination covering health and health-related issues . In addition to serum determinations of B12 , C and folate , associations were examined between these vitamins and measures of cognitive and affective functions . Results : Males and Hispanics had lower serum vitamin B12 , C and folate concentrations than females and NHW respectively . Participants taking a multivitamin supplement ( MVI ) had higher serum vitamin concentrations than those not taking MVI . There were significant associations between serum folate concentrations and measures of cognitive function , not seen with B12 or C , nor between any of the vitamins and affective function . Conclusions : Hispanics , even after adjustments for gender , age , vitamin supplementation , vitamin content of dietary foods , education and household income , had lower serum concentrations of B12 , C and folate than NHW . The most significant associations observed were those between serum folate and various measures of cognitive function , even after adjusting for presence of depression OBJECTIVE The associations of vitamin B(12 ) , folate , and homocysteine with depression were examined in a population -based study . METHOD The authors screened 3,884 elderly people for depressive symptoms . Subjects with positive screening results had psychiatric workups .  Folate , vitamin B(12 ) , and homocysteine blood levels  were compared in 278 persons with depressive symptoms , including 112 with depressive disorders , and 416 r and omly selected reference subjects . Adjustments were made for age , gender , cardiovascular disease , and functional disability . RESULTS Hyperhomocysteinemia , vitamin B(12 ) deficiency , and to a lesser extent , folate deficiency were all related to depressive disorders . For folate deficiency and hyperhomocysteinemia , the association with depressive disorders was substantially reduced after adjustment for functional disability and cardiovascular disease , but for vitamin B(12 ) this appeared independent . CONCLUSIONS The association of vitamin B(12 ) and folate with depressive disorders may have different underlying mechanisms . Vitamin B(12 ) may be causally related to depression , whereas the relation with folate is due to physical comorbidity OBJECTIVE The authors conducted two multicenter sequential parallel comparison design trials to investigate the effect of L-methylfolate augmentation in the treatment of major depressive disorder in patients who had a partial response or no response to selective serotonin reuptake inhibitors ( SSRIs ) .  METHOD In the first trial , 148 out patients with SSRI-resistant major depressive disorder were enrolled in a 60-day study divided into two 30-day periods . Patients were r and omly assigned , in a 2:3:3 ratio , to receive L-methylfolate for 60 days ( 7.5 mg/day for 30 days followed by 15 mg/day for 30 days ) , placebo for 30 days followed by L-methylfolate ( 7.5 mg/day ) for 30 days , or placebo for 60 days . SSRI dosages were kept constant throughout the study . In the second trial , with 75 patients , the design was identical to the first , except that the l-methylfolate dosage was 15 mg/day during both 30-day periods . RESULTS In the first trial , no significant difference was observed in outcomes between the treatment groups . In the second trial , adjunctive L-methylfolate at 15 mg/day showed significantly greater efficacy compared with continued SSRI therapy plus placebo on both primary outcome measures ( response rate and degree of change in depression symptom score ) and two secondary outcome measures of symptom severity . The number needed to treat for response was approximately six in favor of adjunctive L-methylfolate at 15 mg/day . L-Methylfolate was well tolerated , with rates of adverse events no different from those reported with placebo . CONCLUSIONS Adjunctive L-methylfolate at 15 mg/day may constitute an effective , safe , and relatively well tolerated treatment strategy for patients with major depressive disorder who have a partial response or no response to SSRIs Depressed geriatric patients have lower levels of folate ( FOL ) than controls . Also , FOL supplement can reduce depressive morbidity . One hypothesis consistent with this is that FOL deficiency causes a lowering of CNS serotonin that contributes to depression . The present report is from one site of a multicenter study that compared an SSRI ( sertraline ) with a nonspecific tricyclic antidepressant ( nortriptyline ) in geriatric depressed patients . We added measures of FOL at baseline and outcome for 22 depressed patients older than 60 years . Both treatments were effective . At baseline , FOL levels were within the normal range . Higher FOL levels at baseline predicted greater improvement . Further study of FOL interaction with SSRI is warranted . For the group treated with the SSRI , baseline FOL level was a more efficient predictor of improvement , especially for results on a self-rating depression scale ( POMS ) Tetrahydrobiopterin is a cofactor in the synthesis of monoamine neurotransmitters . High neopterin levels generally signal increased immune activation . Both pterins have been investigated in several small clinical studies of depressed patients with conflicting results . Therefore , we examined the relation of plasma biopterin and neopterin with depression in a population -based study . We also studied the association of pterins with folates in depressed persons as this vitamin is required for pterin bio synthesis . We screened 3884 adults aged 60 years and over for depressive symptoms . Screen positive subjects had a psychiatric interview to diagnose DSM-IV disorder .  Plasma pterins and serum folate  were determined in all persons with depressive symptoms ( n=238 ) and r and omly selected non-depressed persons ( n=357 ) . We found no association between the concentration of biopterin or neopterin with depressive symptoms or depressive disorders . However , in depressed persons the relation between pterins and folates was different than in the non-depressed , i.e. neopterin concentrations increased with folate levels in persons with depressive symptoms ( 0.09 per log(nmol/l folate ) ; 95 % CI=0.01 , 0.18 , P=0.03 ) , but not in non-depressed persons ( -0.07 per log(nmol/l folate ) ; 95 % CI=-0.17 , 0.03 , P=0.18 ) . The interaction between depressive symptoms , folate and neopterin was significant ( P=0.03 ) . The study suggests that the relation between folate and pterins is altered in the depressed elderly 5-methyltetrahydrofolate ( MTHF ) is a naturally occurring substance involved in the synthesis of s-adenosyl-l-methionine ( SAMe ) , a major source of methyl groups in the brain . To assess the efficacy of a gastro-resistant , oral preparation of MTHF , 20 elderly patients with a DSM-III-R diagnosis of depressive disorder and a HAM-D-21 score > or = 18 underwent 6-weeks of open-label treatment with 50 mg per day of oral MTHF . Of these 20 patients , 16 completed at least 4 weeks of treatment and showed a markedly significant improvement in their depressive symptoms at endpoint , with 81 % of them being considered responders . There were no clinical ly relevant changes in the routine laboratory tests during the study , and no adverse events considered to be definitely drug-related were reported This was a 4-week r and omized placebo-controlled double-blind study to assess augmentation of open tricyclic 
    Output:
    