title: Depressive symptoms and changes in body weight exert independent and site-specific effects on bone in postmenopausal women exercising for 1 year.
abstract: 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.
authors.affiliation: Department of Exercise and Health Sciences, University of Massachusetts, Boston, 100 Morrissey Blvd., Boston, MA 02125, USA. laurie.milliken@umb.edu
authors.forename: Laura A
authors.initials: LA
authors.lastname: Milliken
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wilhelmy
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Martin
authors.forename: Nuris
authors.initials: N
authors.lastname: Finkenthal
authors.forename: Ellen
authors.initials: E
authors.lastname: Cussler
authors.forename: Lauve
authors.initials: L
authors.lastname: Metcalfe
authors.forename: Terri Antoniotti
authors.initials: TA
authors.lastname: Guido
authors.forename: Scott B
authors.initials: SB
authors.lastname: Going
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Lohman
mesh_terms: 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
chemical_list: D017610:Calcium Compounds