Abstract
OBJECTIVE:Previous studies have reported that depression may play a crucial role in the occurrence of vertebral fractures. However, a clear correlation between depressive disorders and osteoporotic fractures has not been established. We explored the association between depressive disorders and subsequent new-onset vertebral fractures. Additionally, we aimed to identify the potential risk factors for vertebral fracture in patients with a depressive disorder.METHODS:We studied patients listed in the Taiwan National Health Insurance Research Database who were diagnosed with a depressive disorder by a psychiatrist. The comparison cohort consisted of age- and sex-matched patients without a depressive disorder. The incidence rate and hazard ratios of subsequent vertebral fracture were evaluated. We used Cox regression analysis to evaluate the risk of vertebral fracture among patients with a depressive disorder.RESULTS:The total number of patients with and without a depressive disorder was 44,812. The incidence risk ratio (IRR) between these 2 cohorts indicated that depressive disorder patients had a higher risk of developing a subsequent vertebral fracture (IRR=1.41, 95% confidence interval [CI]=1.26–1.57, p<0.001). In the multivariate analysis, the depressive disorder cohort showed a higher risk of vertebral fracture than the comparison cohort (adjusted hazard ratio=1.24, 95% CI=1.11–1.38, p<0.001). Being older than 50 years, having a lower monthly income, and having hypertension, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease, autoimmune disease, or osteoporosis were considered predictive factors for vertebral fracture in patients with depressive disorders.CONCLUSIONS:Depressive disorders may increase the risk of a subsequent new-onset vertebral fracture.
Highlights
Vertebral fractures are a critical public health problem and can result in acute and chronic pain, decreased quality of life, and diminished lifespans [1]
The incidence risk ratio (IRR) of vertebral fracture was significantly higher in patients with a depressive disorder than in the controls (IRR=1.41, 95% CI=1.26–1.57, po0.001)
Multivariate analyses were performed using a Cox regression model to identify the potential risk factors for vertebral fracture in patients with a depressive disorder; as shown in Table 4, the results of these analyses showed that the predictive factors for vertebral fracture in patients suffering from a depressive disorder included being older than 50 years old, having a lower monthly income, and having hypertension, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), autoimmune disease, or osteoporosis
Summary
Vertebral fractures are a critical public health problem and can result in acute and chronic pain, decreased quality of life, and diminished lifespans [1]. In Taiwan, the prevalence of vertebral fracture in women 65 years and older has been reported to be 19.8%, which was higher than the 12.5% in men of the same age group [3]. The risk factors for vertebral fracture include advanced age, female sex, dementia, susceptibility to falling, a history of fracture, alcohol consumption, tobacco use, osteoporosis, estrogen deficiency, impaired eyesight, insufficient physical activity, low body weight, dietary calcium deficiency, and vitamin D deficiency [5,6]
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