Mental illness may be associated with fragility fractures, undiagnosed osteoporosis
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Key takeaways:
- Severe mental illness may be associated with decreased bone mineral density, fragility fractures and osteoporosis.
- Severe mental illnesses included schizophrenia, bipolar disorder or other conditions.
According to published results, severe mental illnesses, such as schizophrenia and bipolar disorder, may be risk factors for decreased bone mineral density, fragility fractures and undiagnosed osteoporosis.
Christina Avgerinou, MD, PhD, MRCGP, senior clinical research associate in the department of primary care and population health at the University College London, and colleagues performed a longitudinal population-based cohort study of 444,480 patients aged 50 years and older who were registered in a primary care database in the United Kingdom between January 2000 and December 2018. All patients had a minimum follow-up of 1 year.
Overall, 50,006 patients had severe mental illness, which was defined as a diagnosis of schizophrenia, bipolar disorder or other “psychosis.”.
Among men, Avgerinou and colleagues found severe mental illness was associated with an increased risk of osteoporosis diagnosis and fragility fractures. They noted the youngest men (aged 50 to 54 years; HR = 2.12) and the oldest men (aged 85 to 99 years; HR = 2.15) were at the highest risk for osteoporosis diagnosis.
Among women, severe mental illness was associated with an increased risk for osteoporosis diagnosis only among the youngest women (aged 50 to 54 years; HR = 1.16). However, Avgerinou and colleagues noted severe mental illness was associated with an increased risk of fragility fractures among women of all ages.
According to the study, the fragility fracture-to-osteoporosis ratio was 2.1 in men with severe mental illness vs. 1.89 in men without severe mental illness. Similarly, the fragility fracture-to-osteoporosis ratio was 1.56 in women with severe mental illness vs. 1.11 in women without severe mental illness
“This study has demonstrated that a diagnosis of severe mental illness is a risk factor for fragility fractures in both men and women, accounting for age, social deprivation, smoking, alcohol and BMI,” Avgerinou and colleagues wrote in the study. “Interventions should be considered to screen for osteoporosis and mitigate the increased risk of fractures in people with severe mental illness.”
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