The Association of Bone Mineral Density and Depression in an Older Population
Abstract
OBJECTIVE: To evaluate the association between bone mineral density (BMD) and measurements of depression in an older population. DESIGN: Population‐based, cross‐sectional study. SETTING: Study subjects were participants in the Cardiovascular Health Study (CHS), a longitudinal, long‐term, follow‐up study, at the University of California Davis (Sacramento, California) and the University of Pittsburgh (Pittsburgh, Pennsylvania) clinical centers. PARTICIPANTS: A random sample of 1,566 Medicare enrollees age 65 and older enrolled in the CHS. MEASUREMENTS: Total hip BMD, measured using dual energy x‐ray absorptiometry (DEXA), after adjustment for multiple covariates, was compared with depression evaluated with the Center for Epidemiological Studies 10‐item Depression Scale (CES‐Dm). Risk factors for osteoporosis were compared in depressed and nondepressed participants. Potential correlates were entered into a regression model. Depression scores were compared in normal, osteopenic, and osteoporotic individuals. RESULTS: Sixteen percent of participants were clinically depressed; 9% had BMDs in the osteoporotic range. Mean BMD was 40 mg/cm 2 lower in those with clinical depression. High CES‐Dm scores were associated with lower BMD ( P < .001) when adjusted for body mass index (BMI), age, kilocalories of activity, estrogen use, gender, race, smoking and drinking. When stratified by race, this remained true for all Caucasians ( P < .01), all African Americans ( P < .05), and when stratified by race and gender the association remained only for all Caucasian women ( P < .001). In women and Caucasian men there was an increase in depression scores among individuals with osteoporotic‐range BMDs. CONCLUSIONS: A significant association was found between BMD and depressive symptoms after adjustment for osteoporosis risk factors. In Caucasians, depressive symptoms were associated with both osteoporotic and osteopenic levels of BMD. Causality cannot be ascribed, with only one measurement of BMD. We postulate that there may be an unmeasured third factor, such as an endogenous steroid, that is responsible for both low BMD and depression. J Am Geriatr Soc 49:732–736, 2001.
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Although the association between depression and loss of bone mineral density has been reported inconsistently, most studies have found low bone mineral density in patients with depressive symptoms or major depressive disorder.
“Although the association between depression and loss of BMD has been reported inconsistently, most studies have found low BMD in patients with depressive symptoms or major depressive disorder (477-483).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [483]
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- Authors
- Robbins, J., Hirsch, C., Whitmer, R., Cauley, J., Harris, T., & Study, F. T. C. H.
- Affiliations
- University of California Davis Medical Center (US)
- University of Pittsburgh (US)
- National Institutes of Health (US)
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2001-06
- Volume
- 49
- Issue
- 6
- Pages
- 732-736
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W2029660235
- Cited by
- 180
- References
- 21
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 9 · 2015: 4 · 2014: 7 · 2013: 10 · 2012: 6
- FWCI
- 7.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc085079-024, n01hc085086-022, 5p60hl015103-15)
- National Heart, Lung, and Blood Institute (HL-35129, N01 HC85086, HL-15103, N01-HC85079)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- bone mineral density, depression, osteoporosis, older adults, hip bone density, osteopenia, osteoporosis risk factors, racial differences, sex differences, depressive symptoms, endogenous steroids, Cardiovascular Health Study
- MeSH terms
- Aged, Analysis of Variance, Black or African American, Bone Diseases, Metabolic, California, Cross-Sectional Studies, Depression, Energy Metabolism, Female, Follow-Up Studies, Humans, Male, Osteoporosis, Pennsylvania, Population Surveillance, Psychiatric Status Rating Scales, Radionuclide Imaging, Risk Factors, Exercise, Absorptiometry, Photon, Bone Density, Body Mass Index, Linear Models, Single-Blind Method, Sex Distribution, Black People, White People, Fractures, Bone
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