Department of Sociology and Anthropology, University of La Verne, La Verne, California, USA.
Gerontologist. 2024 Jun 1;64(6). doi: 10.1093/geront/gnae027.
Although it is well established that psychological disorders and osteoporosis risk are linked, how the relationship manifests is not. This study examines depressive symptoms and a history of psychological problems as potential risk factors for osteoporosis diagnosis, adjudicating between 4 theoretical models rarely tested together. We analyze these models across multiple domains (i.e., demographic, socioeconomic, and health-related), while accounting for bone mineral density (BMD) scans, which have been shown to improve health equity across sex and racial/ethnic identities.
Data from the 2012-2016, nationally representative, population-based, cohort Health and Retirement Study (N = 18,224-18,359) were used to estimate 4 logistic regression models with the outcome of osteoporosis diagnosis. Approximately 50% of the sample identified as female and 50% as male, while about 81% identified as White/European American, 11% as Black/African American, and 8% as another race/ethnicity. The key independent variables were depressive symptoms-measured using two common scales-and a history of psychological problems.
A history of psychological problems and one depressive symptoms measure were associated with the odds of osteoporosis diagnosis in the presence of other known risk factors for osteoporosis.
Support for the theoretical models was limited. Evidence suggests possible directionality; a history of psychological distress may be a risk factor for osteoporosis, though we cannot rule out the other direction. Public health professionals and healthcare providers should consider a history of psychological problems as a risk factor for osteoporosis when deciding whether to recommend a BMD scan.
尽管心理障碍与骨质疏松风险之间的关联已得到充分证实，但两者之间的关系如何尚不清楚。本研究通过分析很少一起测试的 4 种理论模型，研究抑郁症状和心理问题史是否是骨质疏松症诊断的潜在风险因素。我们在多个领域（即人口统计学、社会经济和与健康相关的领域）分析这些模型，同时考虑到骨密度 (BMD) 扫描，这些扫描已被证明可以改善性别和种族/族裔认同方面的健康公平性。
本研究使用来自 2012-2016 年全国代表性、基于人群的队列健康与退休研究（N=18224-18359）的数据，使用骨质疏松症诊断的结果来估计 4 个逻辑回归模型。大约 50%的样本被确定为女性，50%为男性，而约 81%的样本被确定为白种人/欧洲裔美国人，11%为黑种人/非裔美国人，8%为其他种族/族裔。关键的独立变量是使用两种常用量表测量的抑郁症状和心理问题史。
在存在其他已知骨质疏松症风险因素的情况下，心理问题史和一种抑郁症状测量方法与骨质疏松症诊断的几率相关。
对理论模型的支持有限。有证据表明可能存在方向性；心理困扰史可能是骨质疏松症的一个风险因素，但我们不能排除其他方向。公共卫生专业人员和医疗保健提供者在决定是否推荐 BMD 扫描时，应将心理问题史视为骨质疏松症的一个风险因素。
