title: Depressive symptoms and rates of bone loss at the hip in older men.
abstract: In this prospective cohort study, depressive symptoms were associated with higher rates of bone loss in older men. Poorer performance on physical function tests partly explained the association between depressive symptoms and bone loss, suggesting that efforts to increase exercise and improve physical performance in depressed men may be beneficial.
  
  
  BACKGROUND
  The aim of this study was to ascertain whether depressive symptoms are associated with increased rates of bone loss at the hip in older men.
  
  
  METHODS
  A population-based prospective cohort study of 2,464 community-dwelling men, aged 68 and older, enrolled in the Osteoporosis in Men Sleep Ancillary Study had depressive symptoms assessed by the Geriatric Depression Scale (GDS). Subjects were categorized as depressed if GDS ≥6 at the initial examination. Bone mineral density (BMD) at the hip was measured using dual-energy X-ray absorptiometry at the initial and follow-up examination (average 3.4 years between exams). Use of antidepressant medications was assessed by interview and verified from medication containers at the two examinations. A computerized dictionary was used to categorize type of medication.
  
  
  RESULTS
  In a base model adjusted for age, race/ethnicity, and clinic site, the mean total hip BMD decreased 0.70 %/year in 136 men with a GDS score of ≥6 compared to 0.39 %/year in 2,328 men with a GDS score of <6 (p = 0.001). Walking speed and timed chair stand partly explained the association between depressive symptoms and rates of bone loss.
  
  
  CONCLUSIONS
  Depression, as defined by a score of 6 or greater on the Geriatric Depression Scale, is associated with an increased rate of bone loss at the hip in this cohort of older men. Adjustment for walking speed and timed chair stand attenuated the strength of the association, suggesting that differences in physical functioning do partially explain the observed association.
authors.affiliation: Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55415, USA. sdiem@umn.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Diem
authors.forename: S L
authors.initials: SL
authors.lastname: Harrison
authors.forename: E
authors.initials: E
authors.lastname: Haney
authors.forename: J A
authors.initials: JA
authors.lastname: Cauley
authors.forename: K L
authors.initials: KL
authors.lastname: Stone
authors.forename: E
authors.initials: E
authors.lastname: Orwoll
authors.forename: K E
authors.initials: KE
authors.lastname: Ensrud
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage; D015519:Bone Density / Q000502:physiology; D003863:Depression / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005269:Femur / Q000503:physiopathology; D005272:Femur Neck / Q000503:physiopathology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D010809:Physical Fitness / Q000502:physiology / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents