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Mental Health

Longitudinal association of homocysteine with depressive and anxiety symptoms among urban adults: Healthy Aging in Neighborhoods of Diversity across the Life Span study Michael Georgescu* Michael Georgescu May A. Beydoun Christian A. Maino Vieyte Marie T. Fanelli-Kuczmarski, Jason Ashe Hind A. Beydoun Sharmin Hossain Nicole Noren Hooten Michele K. Evans Alan B. Zonderman

To examine longitudinal associations of homocysteine (HCY) with depressive symptoms scores among urban adults, before and after stratifying by sex, race and levels of anxiety. We analyzed data collected on 1,460 Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) participants (baseline age: 30-64y), across Visit 1 (2004-2009), Visit 2 (2009-2013) and Visit 3 (2013-2017). HCY at baseline and z-transformed probability of higher HCY trajectory were measured at baseline visit 1 and estimated across the 3 visits using group-based trajectory models (GBTM), respectively. The 20-item Center for Epidemiologic Studies Depression (CES-D) scale was utilized to compute total and domain-specific depressive symptoms scores. Mixed-effects linear regression models controlled for socio-demographic, lifestyle and selected health characteristics. We found a significant positive association between baseline Loge(LnHcy) [LnHcy] with depressive symptoms over time. A positive and significant cross-sectional association between LnHcy with depressive symptoms was also identified (β [SE]=1.825 [0.883], P=0.039). However, heterogeneity was detected across anxiety levels, with individuals below median anxiety experiencing faster increases in CES-D domain 2 scores (β [SE]=0.041 [0.018], P=0.024). A “High” LnHcy trajectory, identified using GBTM, probability was directly associated with baseline CES-D total score (β [SE]=0.64 [0.28], P=0.021), mainly driven by interpersonal problems. However, there was also a positive association between LnHcy and depressive symptoms for individuals with anxiety scores above the median. Baseline LnHcy positively correlates with depressive symptoms, with variations across anxiety. Specifically, individuals below median experiencing faster increases in the interpersonal sub-domain which was associated with “High” LnHcy trajectory probability in the overall sample.