Author response: letter on ‘Does cadmium exposure contribute to depressive symptoms in the elderly population?

We thank Dr Tomoyuki Kawada1 for his interest in our manuscript entitled 'Does cadmium exposure contribute to depressive symptoms in the elderly population?'.2 In the letter, Dr Kawada depicted three possible reasons for the inconsistent results of our study: limited statistical power, use of blood cadmium as marker of cadmium exposure and the presence of other potential confounding variables.

First, we agree with Dr Kawada's opinion on the limited statistical power of the study regarding the small number of depression patients in the second and the third visit data. In our study, the point estimates for the association between blood cadmium levels and elderly depressive symptoms were not consistent across the three visits. The direction of the point estimate at the second and the third visit should be consistent as long as depression patients are similarly distributed across the quartile group as their distribution at the first…

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