Osteoporosis International

, Volume 20, Issue 8, pp 1309–1320

Depression and low bone mineral density: a meta-analysis of epidemiologic studies

Authors

    • BiostatisticsMayo Clinic
  • J. H. Magnus
    • Department of Community of Sciences, School of Public Health and Tropical MedicineTulane University
  • J. Liu
    • College of Arts and LettersNorthern Arizona University
  • A. F. Bencaz
    • Department of Biostatistics, School of Public Health and Tropical MedicineTulane University
  • J. G. Hentz
    • BiostatisticsMayo Clinic
Review

DOI: 10.1007/s00198-009-0918-x

Cite this article as:
Wu, Q., Magnus, J.H., Liu, J. et al. Osteoporos Int (2009) 20: 1309. doi:10.1007/s00198-009-0918-x

Abstract

Summary

The association between depression and loss of bone mineral density (BMD) has been reported inconsistently. This meta-analysis, which pooled results from 14 qualifying individual studies, found that depression was associated with a significantly decreased BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression.

Introduction

The reported association between depression and loss of BMD has been controversial. This meta-analysis was conducted to determine whether depression and BMD are associated and to identify the variation in some subgroups.

Methods

English-language articles published before October 2008 were used as the data source. A total of six case-controlled and eight cross-sectional studies met prestated inclusion criteria (N = 10,523). Information on study design, participant characteristics, measurements of BMD and depression, and control for potential confounders was abstracted independently by two investigators using a standardized protocol.

Results

Overall, depression was associated with a significant decrease in mean BMD of spine (−0.053 g/cm2 [95% confidence interval {CI} −0.087 to −0.018 g/cm2]) and hip (−0.052 g/cm2 [95% CI −0.083 to −0.022 g/cm2]). A substantially greater BMD decrease was observed in depressed women (−0.076 g/cm2 in spine; −0.059 g/cm2 in hip) and in cases of clinical depression (−0.074 g/cm2 in spine; −0.080 g/cm2 in hip).

Conclusion

Depression is associated with low BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression. Depression should be considered as an important risk factor for osteoporosis.

Keywords

BoneBone densityDepressionDepressive disorderMeta-analysisReview

Abbreviations

BMD

Bone mineral density

BMI

Body mass index

CI

Confidence interval

DSM

Diagnostic and Statistical Manual of Mental Disorders

ROI

Region of interest

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009