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Association of depressive symptoms with incident fractures: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT)

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Abstract

Summary

This 5-year longitudinal study investigated the relationship between depressive symptoms and fracture risk in a large Japanese cohort. Depressive symptoms were a significant risk factor for hip fractures in women.

Purpose

A relationship between depressive symptoms and fractures has not been clearly demonstrated. We aimed to investigate the relationship between depressive symptoms and 5-year fracture risk in the Japan Public Health Center-based Prospective Study for the Next Generation.

Methods

From 2011 to 2016, 114,092 participants were enrolled, and a follow-up survey was conducted 5 years later. We analyzed 30,552 men and 38,063 women aged 40–74 years who had no past fractures at baseline. Presence of depressive symptoms was defined as a modified 11-item Center for Epidemiological Studies Depression Scale score of 8 or higher, a history of depression, or use of antidepressants. Subjects were asked to report vertebral, upper limb, and/or hip fractures, except for traffic or work accidents, that occurred during the follow-up period. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for fracture were analyzed via logistic regression analysis to evaluate the relationship between depressive symptoms and fracture.

Results

Women with depressive symptoms demonstrated a high AOR for hip fractures (AOR: 2.78, 95% CI: 1.30 – 5.92); this result was consistent in post menopause women. In men, this association was not found for any age group or any type of fracture.

Conclusions

Depressive symptoms in women may increase the risk of hip fractures. Further studies are required to explore this relationship in more detail.

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Data Availability

The data and materials used in this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are deeply grateful to all participants and staff members in the present study for their cooperation. This study was conducted under the framework of the Collaborative Cohort Research Network Project of Six National Centers for advanced and specialized medical care.

Funding

This study was supported by the National Cancer Center Research and Development Fund (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010).

Author information

Authors and Affiliations

  1. Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-Machi, Yufu City, Oita, 879-5593, Japan

    Yayoi Funakoshi & Isao Saito

  2. Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama City, Ehime, 790-8566, Japan

    Koutatsu Maruyama

  3. Center for Education and Educational Research, Faculty of Education, Ehime University, 3 Bunkyocho, Matsuyama City, Ehime, 790-0826, Japan

    Tadahiro Kato

  4. Department of Hygiene and Preventive Medicine, Iwate Medical University, 1-1-1 Idaidori, Yahaba-Cho, Shiwa-Gun, Iwate, 028-3694, Japan

    Nobuyuki Takanashi & Kozo Tanno

  5. Department of Public Health Medicine, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-0817, Japan

    Kazumasa Yamagishi

  6. Ibaraki Western Medical Center, 555 Otsuka, Chikusei, Ibaraki, 308-0813, Japan

    Kazumasa Yamagishi

  7. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Isao Muraki

  8. Department of Public Health, Kochi University Medical School, Kohasu, Nankoku-Shi, Kochi, Okoh-Cho, 783-8505, Japan

    Nobufumi Yasuda

  9. Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan

    Kazuhiko Arima & Hiroki Nakashima

  10. Division of Epidemiology, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan

    Taiki Yamaji & Motoki Iwasaki

  11. Division of Cohort Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan

    Motoki Iwasaki, Manami Inoue & Norie Sawada

  12. Division of Prevention, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan

    Manami Inoue

  13. National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saitoasagi, Ibaraki, Osaka, 567-0085, Japan

    Shoichiro Tsugane

  14. International University of Health and Welfare Graduate School of Public Health, Tokyo, 107-8402, Japan

    Shoichiro Tsugane

Authors
  1. Yayoi Funakoshi
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  2. Koutatsu Maruyama
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  3. Tadahiro Kato
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  4. Isao Saito
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  5. Nobuyuki Takanashi
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  6. Kozo Tanno
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  7. Kazumasa Yamagishi
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  8. Isao Muraki
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  9. Nobufumi Yasuda
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  10. Kazuhiko Arima
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  11. Hiroki Nakashima
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  12. Taiki Yamaji
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  13. Motoki Iwasaki
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  14. Manami Inoue
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  15. Shoichiro Tsugane
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  16. Norie Sawada
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Contributions

Yayoi Funakoshi: Conceptualization; Data curation; Formal analysis; Methodology; Visualization; Writing—original draft. Koutatsu Maruyama: Data curation; Investigation; Writing—review & editing. Tadahiro Kato: Data curation; Investigation; Writing—review & editing. Isao Saito: Data curation; Investigation; Methodology; Supervision; Validation; Writing—review & editing. Nobuyuki Takanashi: Data curation; Investigation; Writing—review & editing. Kozo Tanno: Data curation; Investigation; Writing—review & editing. Kazumasa Yamagishi: Data curation; Investigation; Writing—review & editing. Isao Muraki: Data curation; Investigation; Writing—review & editing. Nobufumi Yasuda: Data curation; Investigation; Writing—review & editing. Kazuhiko Arima: Data curation; Investigation; Writing—review & editing. Hiroki Nakashima: Data curation; Investigation; Writing—review & editing. Taiki Yamaji: Project administration; Writing—review & editing. Motoki Iwasaki: Project administration; Writing—review & editing. Manami Inoue: Project administration; Writing—review & editing. Shoichiro Tsugane: Project administration; Writing—review & editing. Norie Sawada: Funding acquisition; Project administration; Supervision; Writing—review & editing. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Isao Saito.

Ethics declarations

Ethics approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki, and informed consent was obtained from all participants. The study was approved by the Institutional Review Board of the National Cancer Center, Tokyo, Japan.

Conflict of interest

Yayoi Funakoshi, Koutatsu Maruyama, Tadahiro Kato, Isao Saito, Nobuyuki Takanashi, Kozo Tanno, Kazumasa Yamagishi, Isao Muraki, Nobufumi Yasuda, Kazuhiko Arima, Hiroki Nakashima, Taiki Yamaji, Motoki Iwasaki, Manami Inoue, Shoichiro Tsugane, and Norie Sawada declare that they have no conflict of interest.

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We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of the authors listed in the manuscript has been approved by all authors.

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Funakoshi, Y., Maruyama, K., Kato, T. et al. Association of depressive symptoms with incident fractures: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT). Osteoporos Int (2024). https://doi.org/10.1007/s00198-024-07106-4

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