Distinct Impacts of Somatic and Cognitive-Affective Depressive Symptom Trajectories on Osteoporosis Risk in Adults Aged 50 Years and Older.

OBJECTIVES

To examine whether 8-year trajectories of total, cognitive-affective, and somatic depressive symptoms are associated with 10-year incident osteoporosis in adults aged 50 years and older.

METHODS

We analyzed 2,816 participants from the English Longitudinal Study of Aging without osteoporosis at baseline or during the exposure period. Depressive symptoms were assessed across four waves using the 8-item Center for Epidemiologic Studies Depression Scale. Participants were classified into five predefined trajectories: consistently low, decreasing, increasing, consistently high, and fluctuating. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals.

RESULTS

Compared with consistently low trajectories, decreasing and fluctuating total depressive symptom trajectories were associated with higher osteoporosis risk in fully adjusted models. For cognitive-affective symptoms, only the consistently high trajectory predicted incident osteoporosis. For somatic symptoms, both consistently high and fluctuating trajectories were independently associated with increased risk.

CONCLUSIONS

Associations between depressive symptom trajectories and osteoporosis risk differed by symptom dimension. Total symptom trajectories showed more heterogeneous patterns after covariate adjustment, whereas domain-specific analyses revealed clearer associations, particularly for somatic symptoms.

CLINICAL IMPLICATIONS: Monitoring persistent or fluctuating somatic depressive symptoms may help identify older adults who could warrant closer attention to osteoporosis risk assessment and preventive counseling.