Association of depressive symptoms with incident fractures: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT)

Yayoi Funakoshi; Koutatsu Maruyama; Tadahiro Kato; Isao Saito; Nobuyuki Takanashi; Kozo Tanno; Kazumasa Yamagishi; Isao Muraki; Nobufumi Yasuda; Kazuhiko Arima; Hiroki Nakashima; Taiki Yamaji; Motoki Iwasaki; Manami Inoue; Shoichiro Tsugane; Norie Sawada

doi:10.1007/s00198-024-07106-4

Association of depressive symptoms with incident fractures: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT)

Osteoporos Int. 2024 May 11. doi: 10.1007/s00198-024-07106-4. Online ahead of print.

Authors

Yayoi Funakoshi¹, Koutatsu Maruyama², Tadahiro Kato³, Isao Saito⁴, Nobuyuki Takanashi⁵, Kozo Tanno⁵, Kazumasa Yamagishi^{6

7}, Isao Muraki⁸, Nobufumi Yasuda⁹, Kazuhiko Arima¹⁰, Hiroki Nakashima¹⁰, Taiki Yamaji¹¹, Motoki Iwasaki^{11

12}, Manami Inoue^{12

13}, Shoichiro Tsugane^{14

15}, Norie Sawada¹²

Affiliations

¹ Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-Machi, Yufu City, Oita, 879-5593, Japan.
² Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama City, Ehime, 790-8566, Japan.
³ Center for Education and Educational Research, Faculty of Education, Ehime University, 3 Bunkyocho, Matsuyama City, Ehime, 790-0826, Japan.
⁴ Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-Machi, Yufu City, Oita, 879-5593, Japan. saitoi@oita-u.ac.jp.
⁵ Department of Hygiene and Preventive Medicine, Iwate Medical University, 1-1-1 Idaidori, Yahaba-Cho, Shiwa-Gun, Iwate, 028-3694, Japan.
⁶ Department of Public Health Medicine, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-0817, Japan.
⁷ Ibaraki Western Medical Center, 555 Otsuka, Chikusei, Ibaraki, 308-0813, Japan.
⁸ Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
⁹ Department of Public Health, Kochi University Medical School, Kohasu, Nankoku-Shi, Kochi, Okoh-Cho, 783-8505, Japan.
¹⁰ Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
¹¹ Division of Epidemiology, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
¹² Division of Cohort Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
¹³ Division of Prevention, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
¹⁴ National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saitoasagi, Ibaraki, Osaka, 567-0085, Japan.
¹⁵ International University of Health and Welfare Graduate School of Public Health, Tokyo, 107-8402, Japan.

PMID: 38733393
DOI: 10.1007/s00198-024-07106-4

Abstract

This 5-year longitudinal study investigated the relationship between depressive symptoms and fracture risk in a large Japanese cohort. Depressive symptoms were a significant risk factor for hip fractures in women.

Purpose: A relationship between depressive symptoms and fractures has not been clearly demonstrated. We aimed to investigate the relationship between depressive symptoms and 5-year fracture risk in the Japan Public Health Center-based Prospective Study for the Next Generation.

Methods: From 2011 to 2016, 114,092 participants were enrolled, and a follow-up survey was conducted 5 years later. We analyzed 30,552 men and 38,063 women aged 40-74 years who had no past fractures at baseline. Presence of depressive symptoms was defined as a modified 11-item Center for Epidemiological Studies Depression Scale score of 8 or higher, a history of depression, or use of antidepressants. Subjects were asked to report vertebral, upper limb, and/or hip fractures, except for traffic or work accidents, that occurred during the follow-up period. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for fracture were analyzed via logistic regression analysis to evaluate the relationship between depressive symptoms and fracture.

Results: Women with depressive symptoms demonstrated a high AOR for hip fractures (AOR: 2.78, 95% CI: 1.30 - 5.92); this result was consistent in post menopause women. In men, this association was not found for any age group or any type of fracture.

Conclusions: Depressive symptoms in women may increase the risk of hip fractures. Further studies are required to explore this relationship in more detail.

Keywords: Cohort study; Depressive symptoms; Epidemiology; Fracture; Prevention.