Psychological resilience and clinical depression on bone loss and fracture

The effects of psychological resilience and depressive symptoms on bone health have not been well-studied. This work aimed to evaluate the association between psychological resilience and depressive symptoms on bone mineral density (BMD) and osteoporotic fracture in community-dwelling adults in Korea. Data from the Chungju Metabolic Disease Cohort were used. Between May 2007 and March 2011, 4029 participants aged 40 years or older underwent a baseline examination, and approximately four years later, they underwent a second examination. BMD was measured, and resilience and depression scales were completed. Participants in the lowest resilience group had lower BMD Z-scores at the femoral neck (0.04 ± 0.53 vs. 0.22 ± 0.950, p < 0.001) and the total hip (0.17 ± 0.98 vs. 0.34 ± 0.92, p < 0.001) compared to those in the highest resilience group. Individuals with clinical depression also had lower BMD Z-scores than those without it. However, resilience status was not associated with the prevalence of osteoporosis at follow-up or incident fracture. In contrast, the odds of osteoporosis were 1.39 (95% CI 1.12-1.71) in women with clinical depression even after adjusting for covariates. In men, clinical depression was not associated with the odds of osteoporosis. Among non-osteoporotic participants, subjects with clinical depression had a 1.40-fold (95% CI 1.07-1.92) higher fracture incidence than those without depression. In this study, low resilience did not appear to negatively affect the prevalence of osteoporosis at follow-up or fracture. Among non-osteoporotic participants, depressive individuals have a potentially increased risk of fracture compared with those without clinical depression.