Age-related bone loss ‘accelerated by depression’
MedWire News: Depression in elderly men is associated with accelerated bone loss, a prospective cohort study indicates.
The association is partially explained by poorer neuromuscular functioning, say Susan Diem (University of Minnesota, Minneapolis, USA) and co-authors writing in Osteoporosis International.
The study involved 2464 community-dwelling men aged 68 years and older who were participating in the Osteoporosis in Men Sleep Ancillary Study. The men underwent dual-energy X-ray absorptiometry measurement of bone mineral density (BMD) and completed the 15-item Geriatric Depression Scale (GDS) at baseline. BMD was reassessed on average 3.4 years later.
The prevalence of depression at baseline (as indicated by a GDS score of 6 or higher) was 5.5%, report Diem et al.
Depressed men tended to be older and in poorer health, with greater impairment of activities of daily living, than their nondepressed counterparts. Depressed men were also more likely to smoke and had poorer physical functioning, as indicated by slower walking speeds and a longer time to rise from sitting.
Mean rates of bone loss at the total hip were significantly higher in depressed than in nondepressed men, at age-adjusted rates of -0.70% versus -0.39% per year.
However, this difference was attenuated by additional adjustment for multiple measures of physical functioning, to -0.56% versus -0.40% per year.
A secondary analysis revealed a graded association between the number of depressive symptoms and the rate of bone loss, such that the rate was lowest in men with a GDS score of 0-2, intermediate in those with a score of 3-5, and highest in men who scored 6 and above.
"Evidence of depression… was associated with an approximate 1.8-fold increase in the annualized rate of bone loss… in this cohort of older men, due in part to poorer neuromuscular functioning among those men with depression," Diem and co-authors conclude.
They suggest: "Future research might focus on interventions to increase exercise in this population: structured physical activity has been shown to improve performance on measures of physical function, including gait speed and ability to rise from a chair, and some evidence suggests that exercise can improve the symptoms of depression."
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By Joanna Lyford