Osteoporosis Nearly Doubles Risk of Older-Age Depression

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Older adults with osteoporosis face an approximate 70 percent higher likelihood of experiencing depressive symptoms than their healthy peers, according to findings from a recent study.

The most common form of arthritis globally, osteoporosis is characterized by low bone mass and deterioration of bone tissue. According to a study published in 2023, the condition affects 14.8 percent of the global population older than 30 years.

For their cross-sectional study, an international team of investigators obtained data from the US National Health and Nutrition Examination Survey (NHANES) ranging from 2005 to 2020. The osteoporosis diagnosis was based on bone mineral density of the femoral neck measured by dual-energy X-ray absorptiometry. Depression was characterized as a Patient Health Questionnaire-9 score of more than five with a score of at least 10 as probable depression.

The study included 11,603 adults aged at least 50 years old and 5.2 percent with osteoporosis. Of the participants with osteoporosis, 31.9 percent had depressive symptoms and 10% percent had probable depression. Participants with osteoporosis were more likely to be older, non-Hispanic White, current smokers , less likely to have a BMI of at least 25 kg/m2, less likely to have education level greater than college graduate or above, and less likely to be married or living with someone as if married.

After adjusting for sex, age, race/ethnicity, education, marital status, family income, BMI, smoking, physical activity, and alcohol abuse, individuals with osteoporosis were 73 percent more likely to experience depressive symptoms, and 91 percent more likely to experience probable depression. After excluding participants who use antidepressants, the fully adjusted model showed participants with osteoporosis had an 82 percent greater risk of depressive symptoms.

The team said several potential explanations could support the findings. For instance, bone mass loss and deterioration of bone tissues can increase the risk of fractures, comorbidities, or death. Moreover, the condition can cause financial burdens and lead people to avoid moderate-vigorous physical activity due to fear of falls and fractures.

“The long-term disease of osteoporosis could lead to deformity of skeleton that may cause a reduction in self-esteem, inability to meet role expectations, dependence on caregivers but isolation from familiar social relationships, therefore, higher possibility of depression than in healthy people,” investigators wrote.

An original version of this article was published by sister site HCPLive.