The link between depression and bone fractures in rural regions

The prevalence of depression has increased throughout the 21st century. Recent evidence has suggested that depression may be linked with changes in bone health. In this descriptive study, we sought to evaluate the connection between depression and bone fractures to increase awareness and enable possible improvement in the prevention of bone fractures in medically underserved areas such as the Rio Grande Valley (RGV). We conducted a retrospective chart review of electronic medical records within the University of Texas Health RGV database from 2019 to 2022. We analyzed medical records and separated charts into groups that had: a dual diagnosis of depression and a bone fracture (group 1; n = 32), a diagnosis of only a fractured bone (group 2; n = 117), a diagnosis of only depression (group 3; n = 1918), and no diagnosis of depression or fracture (group 4; n = 50,784). We calculated the fracture incidence rate for individuals with and without depression. Depression prevalence and fracture incidence rates were also calculated. Univariable and multiple logistic regression models were used to evaluate the association between fracture and depression in all participants with complete data. All statistical tests were 2-sided and were performed at a significance level of .05. Our findings suggest that the fracture rate for individuals with depression (1.64%) was higher than the fracture incidence rate in individuals without depression (0.23%; P < .00001, 95% CI [0.0117-0.0165]). The depression prevalence in our study (3.69%) was less than the national depression prevalence (8.3%; P < .00001, 95% CI [0.0437-0.0485]). We also observed that the fracture incidence rate in our study (0.28%) was less than the global rate (2.30%; P < .00001, 95% CI [0.0189-0.0215]). Our findings suggest that individuals diagnosed with depression have an increased risk of bone fractures compared to individuals without depression in medically underserved areas. We anticipate that our findings may be used to improve bone health in individuals with depression to prevent future fractures, particularly in areas of low socioeconomic status, similar to the RGV.