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

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.