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Depression, fracture risk, and bone loss: a meta-analysis of cohort studies
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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“The majority of studies directly examining the relationship between AD and BMD in humans report that the use of these medications is associated with low BMD (486).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [486]
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Metadata
- Authors
- Wu, Q., Liu, J., Gallegos-Orozco, J. F., & Hentz, J. G.
- Affiliations
- Mayo Clinic (US)
- Arizona State University (US)
- Corresponding author
- Wu, Q.
- Venue
- Osteoporosis International
- Published
- 2010-03-04
- Volume
- 21
- Issue
- 10
- Pages
- 1627-1635
- ISSN
- 0937-941X (ISSN-L)
- 1433-2965
- 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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