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- Title
Depressive symptoms, bone loss, and fractures in postmenopausal women.
- Authors
Spangler, Leslie; Scholes, Delia; Brunner, Robert L.; Robbins, John; Reed, Susan D.; Newton, Katherine M.; Melville, Jennifer L.; LaCroix, Andrea Z.
- Abstract
<bold>Background: </bold>Osteoporosis and depression may be associated through common physiologic systems or risk factors.<bold>Objective: </bold>To assess the associations between depressive symptoms (Burnam's scale) or antidepressant use and bone outcomes.<bold>Design: </bold>Prospective cohort study.<bold>Participants: </bold>A total of 93,676 postmenopausal women (50 to 79 years old) enrolled in the Women's Health Initiative Observational Study.<bold>Measurements: </bold>Self-reported fractures (n = 14,982) (hip [adjudicated], spine, wrist, and "other"). Analyses included 82,410 women with complete information followed on average for 7.4 years. Bone mineral density (BMD) of the hip (n = 4539), spine (n = 4417), and whole body (n = 4502) was measured at baseline and 3 years in women enrolled at 3 densitometry study sites.<bold>Results: </bold>Overall, there were no statistically significant associations between depressive symptoms or antidepressant therapy and 3-year change in BMD. In a subset of women not using antidepressants, there was a significant difference in whole-body BMD change between women with and without depressive symptoms (P = .05). Depressive symptoms (hazard ratio [HR] 1.08; 95% CI = 1.02 to 1.14) and antidepressant therapy (HR = 1.22; CI = 1.15 to 1.30) independently increased risk of any fracture, the majority of which occurred at "other" anatomic sites. Antidepressant therapy increased the risk of spine fracture (HR = 1.36; CI = 1.14 to 1.63). No associations were observed between depressive symptoms or antidepressant therapy and hip or wrist fracture.<bold>Conclusion: </bold>In this study of postmenopausal women, average age 64, we observed minimal association between depressive symptoms and 3-year changes in either BMD or fracture risk. Antidepressant use was not associated with changes in BMD, but was associated with increased risk of fractures at the spine and "other " anatomic sites.
- Subjects
BONE injuries; DEPRESSED persons; MENTAL depression; ANTIDEPRESSANTS; VITAMIN D deficiency; PSYCHIATRIC drugs; RESEARCH; RESEARCH methodology; MEDICAL cooperation; EVALUATION research; OSTEOPOROSIS; COMPARATIVE studies; POSTMENOPAUSE; BONE density; BONE fractures; LONGITUDINAL method; DISEASE complications
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 5, p567
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-008-0525-0