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Depressive symptoms as a risk factor for osteoporosis and fractures in older Mexican American women

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Abstract

Introduction and hypothesis

Despite higher rates of depression, lower hormone replacement therapy (HRT) use, and inadequate knowledge of factors associated with osteoporosis, Mexican Americans have been understudied with regards to the association between depression, osteoporosis, and fractures. We hypothesized that depression increases the risk for osteoporosis and fractures among older Mexican American women.

Methods

Seven years of prospective data (1993–2001) from the Hispanic Established Populations for Epidemiologic Studies of the Elderly were analyzed for 1,350 women in the Southwest United States who had complete data for at least the first follow-up interview.

Results

Respondents (mean age:75) were generally poorly educated, had low income, and reported poor or fair health. High levels of depressive symptoms were reported by 31%, while new diagnosis of osteoporosis and new fractures were reported by 18 and 13%, respectively. Logistic regression analyses showed that predictors of newly diagnosed osteoporosis included age, high school (HS) education, ever having been an alcoholic, early menopause, hormone replacement therapy, and high levels of depressive symptoms. Factors predictive of new fractures included age, HS education, diabetes, early menopause, and high levels of depressive symptoms.

Conclusions

Depressive symptoms were associated with increased risk of osteoporosis and new fractures, even after controlling for other predictive factors.

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Abbreviations

BMD:

bone mineral density

BMI:

body mass index

CES-D:

Center for Epidemiologic Studies Depression Scale

Hispanic EPESE:

Hispanic Established Populations for the Epidemiologic Study of the Elderly

HPA:

hypothalamic-pituitary-adrenocortical axis

HRT:

hormone replacement therapy

OR:

odds ratio

SSRI:

selective serotonin reuptake inhibitors

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Acknowledgement

Dr. Black gratefully acknowledges NIDDK (R01 DK51261) and National Institute on Aging (T32 AG00262) funding support during data analysis and preparation of the manuscript.

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Authors and Affiliations

  1. Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Howard Hall room 140C, 660 West Redwood Street, Baltimore, MD, 21201, USA

    M. I. Tolea, S. A. Black & O. D. Carter-Pokras

  2. National Institutes of Mental Health, Clinical Neuroendocrinology Branch, Intramural Research Programs, Baltimore, MD, USA

    M. A. Kling

Authors
  1. M. I. Tolea
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  2. S. A. Black
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  3. O. D. Carter-Pokras
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  4. M. A. Kling
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Corresponding authors

Correspondence to M. I. Tolea or O. D. Carter-Pokras.

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Tolea, M.I., Black, S.A., Carter-Pokras, O.D. et al. Depressive symptoms as a risk factor for osteoporosis and fractures in older Mexican American women. Osteoporos Int 18, 315–322 (2007). https://doi.org/10.1007/s00198-006-0242-7

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  • DOI: https://doi.org/10.1007/s00198-006-0242-7

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