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Depressed women may face higher osteoporosis danger

Review on June 19, 2007

Recently, a group of professionals try to understand if women who are depressed would be more likely to develop brittle bones late in life. For that reason, they started a research where they found a link between depression and osteoporosis, a bone-thinning condition caused by a lack of calcium.

Earlier studies have proposed that depression is linked with low bone mineral density, and it is widely accepted that low bone mineral density leads to weaker bones. Until now, however, depression was never directly related to an increased risk of fracture.

The specialists conducted a prospective study in elderly white women who were recruited from population-based listings in the United States. At a second visit (1988-1990), 7414 women completed the 15-item Geriatric Depression Scale and were considered depressed if they reported 6 or more symptoms of depression. The specialists measured bone mineral density (BMD) in the spine and at the second visit and asked participants about incident falls (yes/no) at 4 follow-up visits. Nonvertebral breaks were ascertained for an average of 6 years following the depression measure, and confirmed radiologically. We determined incident vertebral fractures by comparing lateral spine films got at the first visit (1986-1988) with repeat films took an average of 3.7 years.

depression chart

Opposing to earlier results, the study discovered no differences in average bone mineral density between depressed and nondepressed women. Even without a disparity in bone density, however, depressed women were at greater danger for rupture. "This investigation highlights the severe disabilities linked with depression," said principal investigator Mary A. Whooley, SFVAMC staff physician and UCSF assistant professor of medicine.

"Better diagnosis and therapy of depression may guide to decreased fracture", she added.

Deprived diet is a well-known contributory factor to osteoporosis, or brittle bone disease, in elderly. But it is probable, as other investigations have pointed out, that increased levels of the hormone produced by stress, cortisol, could badly affect bone tissue.

Over three years, 329 of them underwent a hip fracture, and they were all asked questions linking to loneliness, life satisfaction, sleep disorders, anxiety and general mood. Traditional factors known to raise the risk that falling will fracture a hip, such as body weight, smoking, inactivity and other illness were taken into account.

Elderly people are falling down like ninepins, but damage rates are quite short, in terms of actually getting serious injury like a broken hip. It is possible that depressed people are not looking after their diet as well, and this is causing osteoporosis."

As a conclusion the research pointed out that older women with depression were at increased risk of falls and fractures compared with older women without depression.

Note: This story has been adapted from a news release issued by JAMA and Archives Journals.

  • Mary A. Whooley, MD; Kevin E. Kip, MPH et al. "Depression, Falls, and Risk of Fracture in Older Women." JAMA, Vol. 159,N° 5.(1999)