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Examining the Relationship between Depressive Symptoms and Osteoporosis in Middle-Aged and Older Adults: A 6-Year Regression and 8-Year Trajectory Analysis from Elsa and Hrs Cohorts
Background and Aims: As a leading contributor to fractures among elderly populations, osteoporosis continues to present uncertainties regarding its complete spectrum of determinants. Although conventional elements are extensively documented, emerging research has focused on psychological determinants, with specific attention to depression-related symptoms as possible mediators of bone mineral loss. This investigation seeks to examine associations between depression-related symptoms and osteoporosis, along with longitudinal patterns of psychological distress and osteoporosis development, leveraging datasets from the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS).
Method: Longitudinal data spanning six years were obtained from the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS), incorporating individuals aged 45-85 years during initial enrollment. Psychological distress was measured using the CES-D instrument, while osteoporotic status was identified through clinician-confirmed self-reports. Multivariate logistic analyses explored relationships between psychological distress indicators and bone mineral loss, with covariates including socioeconomic parameters, lifestyle factors, and comorbid states. Furthermore, Cox regression analyses investigated temporal patterns of psychological distress in relation to osteoporosis progression, controlling for population characteristics, behavioral modifications, and pre-existing medical diagnoses. Temporal risk quantification was performed through hazard ratio (HR) estimations.
Result: Both cohort analyses revealed significant positive correlations between psychological distress indicators and osteoporosis likelihood. Within the ELSA cohort, the adjusted OR reached 1.003 (95% CI* 1.001-1.005, p<0.01) for bone mineral loss probability, whereas the HRS dataset demonstrated stronger associations at OR=1.010 (95% CI* 1.003-1.010, p<0.001). Longitudinal assessments of psychological distress patterns indicated participants exhibiting declining or persistently elevated psychological distress manifested 6.12-fold increased osteoporosis risks compared to stable low-distress groups (HR=6.12; 95% CI*:3.18–17.07).
Conclusion: Psychological distress indicators demonstrate significant correlations with elevated osteoporosis likelihood, while depressive disorders potentially constitute autonomous etiological determinants.
Keywords: Depressive symptoms, Osteoporosis, Middle-aged and elderly people, Cohort analysis, Risk association
Lian, Zheng and Zhu, Kai and Han, Shuo and Qu, Changpeng and Su, Kunpeng and Ma, Xuexiao and Tao, Hao, Examining the Relationship between Depressive Symptoms and Osteoporosis in Middle-Aged and Older Adults: A 6-Year Regression and 8-Year Trajectory Analysis from Elsa and Hrs Cohorts. Available at SSRN: https://ssrn.com/abstract=5151070 or http://dx.doi.org/10.2139/ssrn.5151070
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