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Cited by 109Bone health and osteoporosis researchBone Metabolism and DiseasesCardiac Health and Mental Health

Depression, fracture risk, and bone loss: a meta-analysis of cohort studies

Wu, Q., Liu, J., Gallegos-Orozco, J. F., Hentz, J. G.·2010·Osteoporosis International
DOI 10.1007/s00198-010-1181-x
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Abstract

Unlabelled Whether depression can increase the risk of bone fractures is uncertain. This meta-analysis, which pooled results from 14 qualifying individual cohort studies, found that depression was associated with a significantly increased risk of fractures and bone loss.Introduction The effect of depression on the risk of bone fractures is controversial. We conducted a meta-analysis of prospective studies that examined the risk of osteoporotic fractures and bone loss associated with depression.Methods We searched databases and reviewed citations in relevant articles to identify cohort studies that met prestated inclusion criteria; 14 studies were identified. Information on study design, participant characteristics, exposure and outcome measures, control for potential confounders, and risk estimates was abstracted independently by two investigators using a standardized protocol. Data were pooled by use of a random-effects model.Results In studies that reported fracture outcomes as hazard ratios (HRs) (six studies [n = 108,157]), depression was associated with a 17% increase in fracture risk (HR = 1.17; 95% confidence interval [CI], 1.00-1.36; P = 0.05); in studies that reported risk ratios as fracture outcomes (four studies [n = 33,428]), depression was associated with a 52% increase in risk (risk ratio, 1.52; 95% CI, 1.26-1.85; P < 0.001). In studies that reported bone mineral density as an outcome (five studies [n = 8,931]), depression was associated with a reduced annualized bone loss rate of 0.25% (0.05-0.45%; P = 0.02) at the hip and 0.29% (-0.07-0.64%; P = 0.11) at the spine. The HR for the three studies (n = 14,777) that did not adjust for antidepressant treatment was 1.30 (95% CI, 1.11-1.52; P = 0.01), and the HR for the three studies (n = 93,380) that did adjust for antidepressant treatment was 1.05 (95% CI, 0.86-1.29; P = 0.6).Conclusion Evidence supports an association between depression and increased risk of fracture and bone loss that may be mediated by antidepressants.

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Authors
Wu, Q., Liu, J., Gallegos-Orozco, J. F., & Hentz, J. G.
Affiliations
  • Mayo Clinic (US)
  • Arizona State University (US)
Corresponding author
Wu, Q.
ORCID
Venue
Osteoporosis International
Publisher
Springer Science and Business Media LLC
Published
2010-03-04
Volume
21
Issue
10
Pages
1627-1635
ISSN
  • 0937-941X (ISSN-L)
  • 1433-2965
DOI
10.1007/s00198-010-1181-x
OpenAlex
W2007166994
Cited by
109
References
50
Citations by year
2026: 1 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 3 · 2019: 6 · 2018: 9 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 9 · 2013: 6 · 2012: 15
FWCI
1.63
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Osteoporosis International (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
depression, osteoporotic fractures, fracture risk, bone loss, bone mineral density, antidepressant treatment, hip fracture, spinal fractures, bone health, mental health and physical health comorbidity, sex differences in fracture risk, alcohol consumption, physical activity, body mass index, socioeconomic status, depression duration, comorbid depression
MeSH terms
Adult, Aged, Aged, 80 and over, Antidepressive Agents, Depression, Depressive Disorder, Female, Humans, Male, Middle Aged, Osteoporosis, Risk Assessment, Osteoporotic Fractures

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