Depressive symptoms and changes in body weight exert independent and site-specific effects on bone in postmenopausal women exercising for 1 year.
BACKGROUND
Lower bone mineral density (BMD) has been documented in clinically depressed populations, and depression is the second most common chronic medical condition in general medical practice. Therefore, the purpose of this study was to determine whether depressive symptoms, vitality, and body weight changes were related to 1-year BMD changes after accounting for covariates.


METHODS
Healthy postmenopausal women (n=320; 40-65 years) were recruited, and 266 women completed the study. Participants were 3-10 years postmenopausal, sedentary, and either taking hormone replacement therapy (1-3.9 years) or not taking it (at least 1 year). Exclusion criteria were: current smoking status, history of fractures, low BMD, body mass index>32.9 or <19.0, or use of bone altering medications. Regional BMD was measured from dual-energy x-ray absorptiometry at baseline and 1 year. Self-reported depressive symptoms and vitality were measured using standard questionnaires.


RESULTS
Both the vitality and depressive symptoms scores were related to BMD changes at the femur neck but not at the greater trochanter or spine. Weight change was a predictor of BMD changes in the trochanter and spine but not in the femoral neck. Weight change and vitality and/or depressive symptoms had differential and site-specific effects on BMD changes at the hip. Vitality and depressive symptoms related to femoral neck changes and weight change related to greater trochanter changes.


CONCLUSIONS
The negative impact of depressive symptoms on BMD in this population of postmenopausal women was independent of body weight or other behavioral factors such as calcium compliance or exercise.
Milliken
Laura A
LA
Department of Exercise and Health Sciences, University of Massachusetts, Boston, 100 Morrissey Blvd., Boston, MA 02125, USA. laurie.milliken@umb.edu
Wilhelmy
Jennifer
J
Martin
Catherine J
CJ
Finkenthal
Nuris
N
Cussler
Ellen
E
Metcalfe
Lauve
L
Guido
Terri Antoniotti
TA
Going
Scott B
SB
Lohman
Timothy G
TG
D000328:Adult; D000368:Aged; D001835:Body Weight; D015519:Bone Density; D017610:Calcium Compounds / Q000008:administration & dosage*; D003866:Depressive Disorder / Q000175:diagnosis*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D017698:Postmenopause / Q000523:psychology; D011336:Probability; D012016:Reference Values; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain
D017610:Calcium Compounds