Association of depressive symptoms with incident fractures: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT)

• Published in: Osteoporosis international 2024-07, Vol.35 (7), p.1261-1271
• Main Authors: Funakoshi, Yayoi, Maruyama, Koutatsu, Kato, Tadahiro, Saito, Isao, Takanashi, Nobuyuki, Tanno, Kozo, Yamagishi, Kazumasa, Muraki, Isao, Yasuda, Nobufumi, Arima, Kazuhiko, Nakashima, Hiroki, Yamaji, Taiki, Iwasaki, Motoki, Inoue, Manami, Tsugane, Shoichiro, Sawada, Norie
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antidepressants; Depression - epidemiology; Endocrinology; Epidemiology; Female; Follow-Up Studies; Fractures; Hip; Hip Fractures - epidemiology; Hip Fractures - etiology; Hip joint; Humans; Incidence; Japan - epidemiology; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Menopause; Mental depression; Middle Aged; Original Article; Orthopedics; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; Osteoporotic Fractures - psychology; Prospective Studies; Public health; Rheumatology; Risk Factors; Vertebrae; Womens health
• ISSN: 0937-941X; 1433-2965; 1433-2965
• DOI: 10.1007/s00198-024-07106-4

Summary This 5-year longitudinal study investigated the relationship between depressive symptoms and fracture risk in a large Japanese cohort. Depressive symptoms were a significant risk factor for hip fractures in women. Purpose A relationship between depressive symptoms and fractures has not been clearly demonstrated. We aimed to investigate the relationship between depressive symptoms and 5-year fracture risk in the Japan Public Health Center-based Prospective Study for the Next Generation. Methods From 2011 to 2016, 114,092 participants were enrolled, and a follow-up survey was conducted 5 years later. We analyzed 30,552 men and 38,063 women aged 40–74 years who had no past fractures at baseline. Presence of depressive symptoms was defined as a modified 11-item Center for Epidemiological Studies Depression Scale score of 8 or higher, a history of depression, or use of antidepressants. Subjects were asked to report vertebral, upper limb, and/or hip fractures, except for traffic or work accidents, that occurred during the follow-up period. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for fracture were analyzed via logistic regression analysis to evaluate the relationship between depressive symptoms and fracture. Results Women with depressive symptoms demonstrated a high AOR for hip fractures (AOR: 2.78, 95% CI: 1.30 – 5.92); this result was consistent in post menopause women. In men, this association was not found for any age group or any type of fracture. Conclusions Depressive symptoms in women may increase the risk of hip fractures. Further studies are required to explore this relationship in more detail.