Depression, antidepressants, and bone mineral density in a population-based cohort

Briana Mezuk, William W. Eaton, Sherita Hill Golden, Gary Wand, Hochang Benjamin Lee

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Background. It is uncertain whether depression and antidepressant use are associated with decreased bone mineral density (BMD) and whether these relationships differ for men and women. Methods. The study used a case-cohort design within the Baltimore Epidemiologic Catchment Area Study, a population-based sample of adults that recently completed its 23-year follow-up. Depression was measured at four time points during the follow-up period by the Diagnostic Interview Schedule. Lower spine BMD was measured at the fourth wave by dual-energy x-ray absorptiometry. The association of BMD with lifetime history of depression and antidepressant medication use was studied using linear regression with bootstrap standard errors. Results. A history of depression was associated with lower spine BMD after controlling for age, sex, race, calcium intake, alcohol use, smoking status, level of physical activity, percent body fat, and antidepressant medication use (-0.140 g/cm2; p < .002). After controlling for depression, antidepressant medication use was associated with decreased BMD in women but not in men (-0.218 g/cm2; p < .016). Conclusions. A history of depression predicted decreased lumbar spine BMD in men and women, and antidepressant use predicted decreased BMD in women even after controlling for depression. The magnitude of the effect of depression on BMD was approximately equivalent to 1 standard deviation in BMD and was therefore clinically significant. Providers should be aware of the physiologic consequences of depression as well as the possible risks to bone strength associated with antidepressant use in older patients.

Original languageEnglish (US)
Pages (from-to)1410-1415
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number12
StatePublished - Dec 2008


  • Antidepressants
  • Bone mineral density
  • Cohort study
  • Depression
  • Osteoporosis

ASJC Scopus subject areas

  • General Medicine


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