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Depressive symptomatology and fracture risk in community-dwelling older men and women

  • Section On Longitudinal Studies
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Abstract

Background and aims: Previous studies suggest that depression increases risk of falls, low bone mineral density, and fractures. Our aim was to evaluate whether depressive symptomatology alone predicts 5-year clinical fracture risk in older adults. Methods: In this secondary analysis of a community-based, prospective cohort study including 4175 women and 1652 men in Canada, depressive symptomatology was assessed at baseline by the mental health inventory-5 (MHI-5) and the mental component score (MCS) of the short form 36 questionnaire (SF-36). Fracture events were assessed annually for five years; all reported incident fragility fractures were confirmed radiographically. Results: Depressive symptomatology did not predict time to first fracture in men (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.45–1.65) or women (HR 1.09, 95% CI 0.86–1.39). Results were similar after controlling for potential confounders. Depressive symptoms were not significantly associated with baseline bone mineral density at the lumbar spine or femoral neck. Women with depressive symptoms were more likely to report falls in the previous month (odds ratio [OR] 1.52, 95% CI 1.12–2.06, p=0.01). This association did not achieve statistical significance in men (OR 1.71, 95% CI 0.96–3.04, p=0.07). Conclusion: In this large, community cohort, depressive symptomatology did not predict five-year risk of clinical fracture. Further research is needed to determine if individuals with major depressive disorder (MDD) are at higher fracture risk and whether neuroendocrine or hormonal dysregulation might contribute to such risk in MDD.

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Authors and Affiliations

  1. Division of Geriatrics, Department of Medicine, Duke University, Durham, USA

    Heather E. Whitson MD & Kenneth W. Lyles

  2. Geriatrics Research, Education, and Clinical Center, Durham Veterans Affairs Medical Center, Durham, USA

    Heather E. Whitson MD & Kenneth W. Lyles

  3. Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, USA

    Linda Sanders

  4. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, USA

    Carl F. Pieper

  5. Department of Psychiatry and Behavioral Sciences, Sociology, and Psychology, Duke University Medical Center, Durham, USA

    Deborah T. Gold

  6. Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA

    Deborah T. Gold & Kenneth W. Lyles

  7. Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada

    Alexandra Papaioannou

  8. Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada

    J. Brent Richards

  9. Department of Medicine, St. Joseph’s Healthcare, McMaster University, Hamilton, Ontario, Canada

    Jonathan D. Adachi

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  1. Heather E. Whitson MD
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  2. Linda Sanders
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  4. Deborah T. Gold
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  7. Jonathan D. Adachi
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  8. Kenneth W. Lyles
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the CaMos Research Group

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Correspondence to Heather E. Whitson MD.

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Whitson, H.E., Sanders, L., Pieper, C.F. et al. Depressive symptomatology and fracture risk in community-dwelling older men and women. Aging Clin Exp Res 20, 585–592 (2008). https://doi.org/10.1007/BF03324888

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  • DOI: https://doi.org/10.1007/BF03324888

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