Association Between Bone Mineral Density and Depressive Symptoms in a Population-Based Sample

Objective: This analysis was conducted to determine the relationship between bone mineral density (BMD) and depressive symptoms in a population-based cohort.

Methods: Data were extracted from the second phase of the Dallas Heart Study (DHS-2), a large, multiethnic population sample in Dallas County, Texas, from September 1, 2007, to December 31, 2009. Depressive symptom severity was measured with the 16-item Quick Inventory of Depressive Symptomatology—Self Report (QIDS-SR16), which is derived from DSM-IV major depressive disorder criteria. BMD was measured using dual-energy x-ray absorptiometry. Multiple linear regressions examined the relationship between QIDS-SR16 score and BMD controlling for age, body mass index, sex, ethnicity, smoking status, alcohol use status, serum 25-hydroxyvitamin D concentration, antidepressant use, and physical activity as measured by total vigorous and moderate metabolic equivalents. Subgroup analyses explored differences related to age.

Results: QIDS-SR16 score was not a significant predictor of either lumbar spine or total hip T-score (β = −0.01, P = .61 and β = −0.02, P = .39) in the overall population (n = 2,285). There was a significant negative interaction term between age and QIDS-SR16 group (β = −0.01, P = .01). In participants aged 60 years or older (n = 465), QIDS-SR16 score was a significant predictor of BMD at the lumbar spine and total hip (β = −0.14, P = .003 and β = −0.12, P = .006, respectively).

Conclusions: QIDS-SR16 score did not significantly predict BMD in the overall DHS-2 sample. There was, however, a significant association observed in participants aged ≥ 60 years. Results suggest that diagnosis and treatment of depressive symptoms may be of clinical importance in older individuals, a subgroup at high risk for osteoporosis and fractures.