Depression tied to increased risk for hip fracture

  • Medicine (Baltimore)

  • International Clinical Digest
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Takeaway

  • A population-based nationwide cohort finds that depression increases the risk for incident hip fracture by 46% in patients ≥50 years, after adjustment for many factors including past medical history.

Why this matters

  • Relationship may be mediated by higher cortisol-induced lowering of bone mineral density.
  • One of the first studies to control for past medical history (hypertension, diabetes, and dyslipidemia).
  • Findings suggest that treating depression has the potential to reduce hip fracture risk.

Study design

  • Retrospective, population-based nationwide cohort from the Korean National Health Insurance Service-National Sample Cohort.
  • Patients with depression (≥50 years of age; years 2002-2013; n=25,197) were matched to 100,788 control patients matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia.
  • Funding: National Research Foundation of Korea.

Key results

  • Across the whole cohort, people with depression were at 46% increased risk for hip fracture (1.1% vs 0.7% in control patients; aHR, 1.46; P<.001>
  • Subgroup analysis found increased risk in old men (≥65 years; aHR, 1.40; P=.047).
  • Subgroup analysis found increased risk in old women (≥65 years; aHR, 1.60; P<.001>

Limitation

  • Observational design.
  • Severity of disease and treatment histories could not be ascertained.