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Anxiety levels may predict fracture risk in postmenopausal women
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Among postmenopausal women with osteoporosis, higher anxiety levels increased risk for bone fracture, according to findings published in Menopause.
“Previous evidences have been found concerning the deleterious effect on bone health due to other mental illnesses, such as depression,” Antonino Catalano, MD, PhD, of the department of clinical and experimental medicine at the University Hospital of Messina, Italy, told Endocrine Today. “The association between anxiety levels and bone health has never been reported before.”
Catalano and colleagues recruited 192 postmenopausal women (mean age, 67.2 years; mean age at menopause, 47.5 years; 78.2% with a previous fracture) between January and April 2017 who had been referred to the University Hospital of Messina’s Outpatient Clinic for Prevention and Treatment of Osteoporosis. They evaluated participants’ fracture risk using the Fracture Risk Assessment Tool (FRAX) and assessed bone mineral density at the lumbar spine and femoral neck using DXA scanning. Additionally, participants completed the SF-36 questionnaire and the Beck Depression Inventory, which the researchers used to assess perceived health status and depression levels, respectively. The Hamilton Anxiety Rating Scale (HAMA) measured anxiety symptom severity, and the researchers used the scores to divide the study participants into three categories: HAMA-1 (n = 87) contained the lowest anxiety scores, HAMA-3 (n = 57) had the highest scores, and scores of those in HAMA-2 (n = 48) were in the middle.
The HAMA-1 group had a lower probability of experiencing a major osteoporotic fracture over 10 years (mean, 20.44% vs. 24.9%; P = .03) vs. the HAMA-3 group and had higher lumbar spine (–2.06 vs. –2.84; P < .001) and femoral neck T-scores (–1.93 vs. –2.21; P < .05). The HAMA-2 group also had higher T-scores than HAMA-3.
Researchers found that age (P = .003), age at menopausal (P = .003) and years since menopause (P = .031) were positively associated with HAMA score.
Catalano and colleagues determined that anxiety levels were significantly associated with BMD measurements at the lumbar spine and femoral neck. Subsequently, the researchers concluded that anxiety levels potentially increased fracture risk in postmenopausal women with osteoporosis.
“Clinical psychologists and psychiatrists who investigate anxiety levels could have more information about the global risk of fracture of their patients, especially postmenopausal women,” Catalano said. “These specialists, together with their patients, have one more reason to work on a clinical psychological support aimed at reducing anxiety levels.” – by Marley Ghizzone
Disclosures: Catalano reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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