Depressive symptoms as a risk factor for osteoporosis and fractures in older Mexican American women.
OBJECTIVE
Despite higher rates of depression, lower hormone replacement therapy (HRT) use, and inadequate knowledge of factors associated with osteoporosis, Mexican Americans have been understudied with regards to the association between depression, osteoporosis, and fractures. We hypothesized that depression increases the risk for osteoporosis and fractures among older Mexican American women.


METHODS
Seven years of prospective data (1993-2001) from the Hispanic Established Populations for Epidemiologic Studies of the Elderly were analyzed for 1,350 women in the Southwest United States who had complete data for at least the first follow-up interview.


RESULTS
Respondents (mean age:75) were generally poorly educated, had low income, and reported poor or fair health. High levels of depressive symptoms were reported by 31%, while new diagnosis of osteoporosis and new fractures were reported by 18 and 13%, respectively. Logistic regression analyses showed that predictors of newly diagnosed osteoporosis included age, high school (HS) education, ever having been an alcoholic, early menopause, hormone replacement therapy, and high levels of depressive symptoms. Factors predictive of new fractures included age, HS education, diabetes, early menopause, and high levels of depressive symptoms.


CONCLUSIONS
Depressive symptoms were associated with increased risk of osteoporosis and new fractures, even after controlling for other predictive factors.
Tolea
M I
MI
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Howard Hall room 140C, 660 West Redwood Street, Baltimore, MD 21201, USA. mtolea@epi.umaryland.edu
Black
S A
SA
Carter-Pokras
O D
OD
Kling
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D004812:Epidemiologic Methods; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D017058:Mexican Americans / Q000523:psychology* / Q000706:statistics & numerical data; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology / Q000523:psychology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology