Ugwu Uchenna Cosmas, Ene Osmond Chukwuemeka
Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria.
BMC Womens Health. 2025 Aug 21;25(1):400. doi: 10.1186/s12905-025-03951-5.
BACKGROUND/OBJECTIVES: Osteoporosis and depression are significant, frequently co-occurring conditions in postmenopausal women, particularly in low- and middle-income countries where access to integrated care is limited. This study aimed to examine the association between osteoporosis and severe depressive symptoms among postmenopausal women attending tertiary outpatient clinics in Nigeria and to identify related demographic, clinical, and lifestyle correlates.
A hospital-based cross-sectional survey was conducted from July 2024 to May 2025 across 12 purposively selected tertiary outpatient clinics representing all six geopolitical zones of Nigeria. A total of 712 postmenopausal women aged ≥ 45 years (mean age: 60.3 years) were recruited using multistage and convenience sampling. Data were collected via a validated, structured questionnaire; the Osteoporosis and Depression Assessment Questionnaire (ODAQ), which included sociodemographic data, menopausal and clinical history, osteoporosis risk factors, PHQ-9 depression screening, and lifestyle variables. Descriptive statistics and chi-square (χ²) tests were used to analyze the association between osteoporosis and depressive symptoms, with significance set at ≤ 0.05.
Severe depressive symptoms were identified in 75.6% of participants. Depression was significantly more common among those with osteoporosis (79.1% vs. 66.5%; χ² = 2.190, = 0.010) and a history of fractures (87.1% vs. 68.2%; χ² = 5.513, = 0.012). Other factors associated with higher depressive symptoms included older age (≥ 60 years), late menopause (after age 50), low parity (≤ 5 pregnancies), comorbid chronic conditions (80.4%; = 0.031), and abnormal anthropometry. Adequate calcium intake was associated with lower depression rates (61.1% vs. 80.9%; = 0.010). Notably, non-smokers and alcohol users exhibited higher depression rates compared to their counterparts, suggesting possible coping behaviors or reporting biases.
The findings underscore a strong association between osteoporosis and severe depressive symptoms in Nigerian postmenopausal women, highlighting the urgent need for integrated mental and bone health interventions in tertiary and primary healthcare settings. Screening for depression should be routinely included in osteoporosis management to improve outcomes in aging women. This study supports WHO’s call for integrated non-communicable disease care and offers evidence to inform policy and clinical practice in similar low-resource settings.
The online version contains supplementary material available at 10.1186/s12905-025-03951-5.
背景/目的：骨质疏松症和抑郁症是绝经后女性中常见且常同时出现的重要病症，在获得综合护理机会有限的低收入和中等收入国家尤为如此。本研究旨在调查尼日利亚三级门诊绝经后女性中骨质疏松症与严重抑郁症状之间的关联，并确定相关的人口统计学、临床和生活方式相关因素。
2024年7月至2025年5月，在尼日利亚六个地缘政治区有针对性选取的12家三级门诊进行了一项基于医院的横断面调查。采用多阶段和便利抽样法，共招募了712名年龄≥45岁（平均年龄：60.3岁）的绝经后女性。通过一份经过验证的结构化问卷收集数据；骨质疏松症和抑郁症评估问卷（ODAQ），其中包括社会人口统计学数据、绝经和临床病史、骨质疏松症风险因素、PHQ-9抑郁筛查以及生活方式变量。采用描述性统计和卡方（χ²）检验分析骨质疏松症与抑郁症状之间的关联，显著性设定为≤0.05。
75.6%的参与者存在严重抑郁症状。抑郁症在患有骨质疏松症的人群中明显更为常见（79.1%对66.5%；χ² = 2.190，P = 0.010）以及有骨折史的人群中（87.1%对68.2%；χ² = 5.513，P = 0.012）。与较高抑郁症状相关的其他因素包括年龄较大（≥60岁）、绝经较晚（50岁以后）、低生育次数（≤5次怀孕）、合并慢性疾病（80.4%；P = 0.031）以及人体测量异常。充足的钙摄入量与较低的抑郁症发生率相关（61.1%对80.9%；P = 0.010）。值得注意的是，与不吸烟和不饮酒者相比，吸烟和饮酒者的抑郁症发生率更高，这表明可能存在应对行为或报告偏差。
研究结果强调了尼日利亚绝经后女性中骨质疏松症与严重抑郁症状之间的紧密关联，凸显了在三级和初级医疗保健环境中进行精神和骨骼健康综合干预的迫切需求。在骨质疏松症管理中应常规纳入抑郁症筛查以改善老年女性的治疗效果。本研究支持世界卫生组织关于综合非传染性疾病护理的呼吁，并为类似资源匮乏环境下的政策和临床实践提供了依据。
在线版本包含可在10.1186/s12905-025-03951-5获取的补充材料。
