Prior studies suggest that stressful life events may increase adverse health outcomes, including falls and possibly fractures. The current study builds on these findings and examines whether stressful life events are associated with increased bone loss.

4388 men aged ≥65 years in the Osteoporotic Fractures in Men study completed total hip bone mineral density (BMD) measures at baseline and visit 2, approximately 4.6 years later, and self-reported stressful life events data mid-way between baseline and visit 2, and at visit 2. We used linear regression to model the association of stressful life events with concurrent annualized total hip BMD loss, and log binomial regression or Poisson regression to model risk of concurrent accelerated BMD loss (>1 SD more than mean annualized change).

75.3% of men reported ≥1 type of stressful life event, including 43.3% with ≥2 types of stressful life events. Mean annualized BMD loss was −0.36% (SD 0.88) and 13.9% of men were categorized with accelerated BMD loss (about 5.7% or more total loss). Rate of annualized BMD loss increased with the number of types of stressful life events after adjustment for age (p<0.001), but not after multivariable adjustment (p=0.07). Multivariable-adjusted risk of accelerated BMD loss increased with the number of types of stressful life events (RR, 1.10 [95% CI, 1.04–1.16]) per increase of 1 type of stressful life event). Fracture risk was not significantly different between stressful life event-accelerated bone loss subgroups (p=0.08).

In these older men, stressful life events were associated with a small, dose-related increase in risk of concurrent accelerated hip bone loss. Low frequency of fractures limited assessment of whether rapid bone loss mediates any association of stressful life events with incident fractures. Future studies are needed to confirm these findings and to investigate the mechanism that may underlie this association.