Association of depressive symptoms with bone mineral density in older men: a population-based study

Thirty percent of hip fractures occur in men; nevertheless, the determinants of osteoporosis in men are unclear.

We assessed the association of ultrasound-derived bone mineral density (UD-BMD) with depressive symptoms in a population-based study. We assessed the association of 30-item Geriatric Depression Scale (GDS) score with the ultrasound-derived T-score, Z-score, and Stiffness index in all 306 subjects aged 75 + living in Tuscania (Italy).

In multivariable linear regression analysis, GDS was associated among men with the ultrasound-derived T-score (beta = -0.09; 95% CI = -0.15 to -0.03; p = 0.003), Z-score (beta = -0.07; 95% CI = -0.13 to -0.01; p = 0.032), and the Stiffness index (beta = -0.90; 95% CI = -1.64 to -0.16; p = 0.018) after adjusting for potential confounders. No significant associations were observed in women. In linear discriminant analysis, the GDS score cutoff that best predicted osteoporosis was >or=19. Participants with mild to severe depressive symptoms had threefold increased probability of having an ultrasound-derived T-score < -2.5.

Depressive symptoms are independently associated with all UD-BMD parameters. As depression is a common feature among older populations, and because subjects with depression are infrequent users of preventive services, older men with depression should be prompted to undergo screening for osteoporosis. Conversely, assessment for depression should be performed in older men with diagnosis of osteoporosis.