Osteoporosis International

, Volume 20, Issue 8, pp 1309–1320

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

  • Q. Wu
  • J. H. Magnus
  • J. Liu
  • A. F. Bencaz
  • J. G. Hentz



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.


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.


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.


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).


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.


Bone Bone density Depression Depressive disorder Meta-analysis Review 



Bone mineral density


Body mass index


Confidence interval


Diagnostic and Statistical Manual of Mental Disorders


Region of interest


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • Q. Wu
    • 1
  • J. H. Magnus
    • 2
  • J. Liu
    • 4
  • A. F. Bencaz
    • 3
  • J. G. Hentz
    • 1
  1. 1.BiostatisticsMayo ClinicScottsdaleUSA
  2. 2.Department of Community of Sciences, School of Public Health and Tropical MedicineTulane UniversityNew OrleansUSA
  3. 3.Department of Biostatistics, School of Public Health and Tropical MedicineTulane UniversityNew OrleansUSA
  4. 4.College of Arts and LettersNorthern Arizona UniversityFlagstaffUSA

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