Association between depression and bone mineral density in community-dwelling older men and women in Korea

Objectives: Previous research suggested a significant correlation between depression and osteoporosis, but little is known for the elderly Asian population. We investigated an association between depression and bone mineral density (BMD) in the Korean elderly. Study design: Cross-sectional data analysis of a community-based study, Kangwha Island, South Korea. Main outcome measures: BMD, measured at the os calcis using a quantitative ultrasound device, was expressed as stiffness index and T-score. Depressive symptoms were evaluated by the Korean version of Beck Depression Inventory (K-BDI). Depression was defined as a K-BDI score of 16 or higher. Participants also completed a questionnaire, including demographic factors, metabolic abnormalities, and health-related lifestyle factors. Results: A total of 932 local residents (422 men and 510 women) aged 60-80 years completed the questionnaires and baseline BMD evaluation. Men with depression had a significantly lower stiffness index compared to those without depression in an age-adjusted (77.2 ± 5.2 vs. 86.0 ± 1.5, p = 0.002) and a multivariate-adjusted model (78.5 ± 5.2 vs. 85. 9 ± 1.5, p = 0.007). Correspondingly, men with depression had an increased probability of having an osteoporosis (T-score ≤ -2.5) compared to those without depression; the age-adjusted odds ratio was 2.86 (95% CI, 1.36-6.01) and the multivariate-adjusted odds ratio was 2.69 (95% CI, 1.26-5.76). However, no significant association was observed in older women. Conclusions: Depression was significantly associated with lower BMD in Korean older men, but not in women.