Depressive symptoms, bone loss, and fractures in postmenopausal women

Leslie Spangler, Delia Scholes, Robert L. Brunner, John A Robbins, Susan D. Reed, Katherine M. Newton, Jennifer L. Melville, Andrea Z. Lacroix

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

BACKGROUND: Osteoporosis and depression may be associated through common physiologic systems or risk factors. OBJECTIVE: To assess the associations between depressive symptoms (Burnam's scale) or antidepressant use and bone outcomes. DESIGN: Prospective cohort study. PARTICIPANTS: A total of 93,676 postmenopausal women (50 to 79 years old) enrolled in the Women's Health Initiative Observational Study. MEASUREMENTS: 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. RESULTS: 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. CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)567-574
Number of pages8
JournalJournal of General Internal Medicine
Volume23
Issue number5
DOIs
StatePublished - May 2008

Fingerprint

Bone Fractures
Antidepressive Agents
Depression
Bone Density
Spine
Hip
Wrist
Densitometry
Women's Health
Therapeutics
Osteoporosis
Observational Studies
Cohort Studies
Prospective Studies
Bone and Bones

Keywords

  • Antidepressants
  • Bone density
  • Depressive symptoms
  • Fractures
  • Prospective

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

Cite this

Spangler, L., Scholes, D., Brunner, R. L., Robbins, J. A., Reed, S. D., Newton, K. M., ... Lacroix, A. Z. (2008). Depressive symptoms, bone loss, and fractures in postmenopausal women. Journal of General Internal Medicine, 23(5), 567-574. https://doi.org/10.1007/s11606-008-0525-0

Depressive symptoms, bone loss, and fractures in postmenopausal women. / Spangler, Leslie; Scholes, Delia; Brunner, Robert L.; Robbins, John A; Reed, Susan D.; Newton, Katherine M.; Melville, Jennifer L.; Lacroix, Andrea Z.

In: Journal of General Internal Medicine, Vol. 23, No. 5, 05.2008, p. 567-574.

Research output: Contribution to journalArticle

Spangler, L, Scholes, D, Brunner, RL, Robbins, JA, Reed, SD, Newton, KM, Melville, JL & Lacroix, AZ 2008, 'Depressive symptoms, bone loss, and fractures in postmenopausal women', Journal of General Internal Medicine, vol. 23, no. 5, pp. 567-574. https://doi.org/10.1007/s11606-008-0525-0
Spangler, Leslie ; Scholes, Delia ; Brunner, Robert L. ; Robbins, John A ; Reed, Susan D. ; Newton, Katherine M. ; Melville, Jennifer L. ; Lacroix, Andrea Z. / Depressive symptoms, bone loss, and fractures in postmenopausal women. In: Journal of General Internal Medicine. 2008 ; Vol. 23, No. 5. pp. 567-574.
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