Anxiety and bone health

Higher levels of anxiety increase fracture risk in postmenopausal women.

Anxiety has already been shown to take its toll on the human body in many ways, including increased risk for heart disease and gastrointestinal disorders. Now a new study demonstrates how anxiety levels are linked to an increased risk of bone fractures in postmenopausal women.

Fracture risk is a major concern for women as they age, with one in three women worldwide estimated to suffer an osteoporosis-related fracture during her lifetime. With people living longer, the frequency of osteoporotic fractures is growing and therefore driving up healthcare costs. This has led to an increased focus on accurately assessing patients for fracture risk.

Previous studies have shown that participants with anxiety disorders were 1.79 times more likely to develop osteoporosis than were those without anxiety. In the article "Anxiety levels predict fracture risk in postmenopausal women assessed for osteoporosis," study results demonstrate how anxiety levels in postmenopausal women are associated with bone mineral density, a key indicator of fracture risk, of the lumbar spine and femoral neck.

Of the 192 postmenopausal women recruited to the study, those with the lowest levels of anxiety showed a lower probability of fracture than did the women with higher anxiety scores. In addition, anxiety levels were significantly related to age, menopause age, years since menopause, and depressive symptoms.

Abstract

OBJECTIVE:
There has been increasing interest in the association of psychiatric disorders with fracture risk. This study aimed at investigating the role of severity of anxiety in bone health.

METHODS:
Multiple clinical risk factors for fractures, the Fracture Risk Assessment Tool score, the bone mineral density (BMD) at the lumbar spine and femoral neck, Hamilton Anxiety Rating Scale (HAMA) scores, Beck Depression Inventory scores, and the 36-Item Short Form Health Survey (SF-36) scores for evaluation of the quality of life were determined, and x-ray vertebral morphometry was carried out in postmenopausal women referred for osteoporosis.

RESULTS:
Of the 192 women recruited (mean age 67.5 ± 9.5 years), participants allocated to the tertile of the lowest HAMA scores (HAMA-1) showed a lower probability of fracture than did participants with the highest scores (HAMA-3) (20.44 ± 9.3 vs 24.94 ± 13%, respectively; P = 0.01), and the same trend was observed when comparing the HAMA-2 and HAMA-3 tertiles. Women in the HAMA-3 group exhibited lower lumbar T-score vales in the lumbar spine than did women in the HAMA-1 group (-2.84 ± 1.4 vs -2.06 ± 1.2 SD, respectively; P < 0.001) and a lower T-score value in the femoral neck (-2.21 ± 0.9 vs -1.93 ± 0.6 SD, respectively; P < 0.05). Lower T-score values were observed in HAMA-3 than in HAMA-2. A higher prevalence rate of vertebral fractures was observed in HAMA-3 than in HAMA-1, but the difference was not significant. Anxiety levels were significantly related to age, menopausal age, years since menopause, and depressive symptoms, and a multiple regression analysis was predictive of reduced BMD in the lumbar spine (β = -0.00672, SE = 0.001, P = 0.0002).

CONCLUSION:
In postmenopausal women, anxiety levels were associated with BMD in the lumbar spine and femoral neck. 

Reference

Catalano A, Martino G, Bellone F, Gaudio A, Lasco C, Langher V, Lasco A, Morabito N. Anxiety levels predict fracture risk in postmenopausal women assessed for osteoporosis.
 Menopause. 2018 May 7. doi: 10.1097/GME.0000000000001123. [Epub ahead of print]

Content updated May 2018