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Depression, Antidepressants, and Bone Health in Older Adults: A Systematic Review

Identifieur interne : 004012 ( PascalFrancis/Curation ); précédent : 004011; suivant : 004013

Depression, Antidepressants, and Bone Health in Older Adults: A Systematic Review

Auteurs : Marie Anne Gebara [États-Unis] ; Marcie L. O. Shea [États-Unis] ; Kim L. Lipsey [États-Unis] ; Steven L. Teitelbaum [États-Unis] ; Roberto Civitelli [États-Unis] ; Daniel J. Müller [États-Unis, Canada] ; Charles F. Iii Reynolds [États-Unis] ; Benoit H. Mulsant [États-Unis, Canada] ; Eric J. Lenze [États-Unis]

Source :

RBID : Pascal:14-0227293

Descripteurs français

English descriptors

Abstract

OBJECTIVES: To examine the association between depression, antidepressant use, and bone health in older adults and the implications for treatment. DESIGN: Systematic review. SETTING: All studies that measured depression or antidepressant exposure and bone mineral density (BMD). PARTICIPANTS: Adults aged 60 and older. MEASUREMENTS: Age, site of BMD measurement using dual-energy X-ray absorptiometry (DXA), measure of depression or depressive symptoms, association between BMD changes, and depression or antidepressant use. RESULTS: Nineteen observational studies met the final inclusion criteria; no experimental studies were found. Several cross-sectional and longitudinal studies found that depression or depressive symptoms were associated with a decrease in BMD. Few studies and only two longitudinal studies addressed the association between serotonin reuptake inhibitor (SRI) antidepressant use and a decrease in BMD and they had conflicting results. CONCLUSION: Depression and depressive symptoms are associated with low bone mass and accelerated bone loss in older adults; putative mechanisms underlying this relationship are discussed. There is insufficient evidence that SRI antidepressants adversely affect bone health. Thus, a change in current recommendations for the use of antidepressants in older adults is not justified at the present time. Given the high public health significance of this question, more studies are required to determine whether (and in whom) antidepressants may be deleterious for bone health.
pA  
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A03   1    @0 J. Am. Geriatr. Soc.
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A08 01  1  ENG  @1 Depression, Antidepressants, and Bone Health in Older Adults: A Systematic Review
A11 01  1    @1 GEBARA (Marie Anne)
A11 02  1    @1 SHEA (Marcie L. O.)
A11 03  1    @1 LIPSEY (Kim L.)
A11 04  1    @1 TEITELBAUM (Steven L.)
A11 05  1    @1 CIVITELLI (Roberto)
A11 06  1    @1 MÜLLER (Daniel J.)
A11 07  1    @1 REYNOLDS (Charles F. III)
A11 08  1    @1 MULSANT (Benoit H.)
A11 09  1    @1 LENZE (Eric J.)
A14 01      @1 Department of Psychiatry, School of Medicine, Washington University @3 USA @Z 1 aut. @Z 2 aut. @Z 9 aut.
A14 02      @1 Department of Bernard Becker Medical Library, School of Medicine, Washington University @3 USA @Z 3 aut.
A14 03      @1 Department of Pathology, School of Medicine, Washington University @3 USA @Z 4 aut.
A14 04      @1 Department of Internal Medicine, School of Medicine, Washington University @2 St. Louis, Missouri @3 USA @Z 4 aut. @Z 5 aut.
A14 05      @1 Centre for Addiction and Mental Health @3 USA @Z 6 aut. @Z 8 aut.
A14 06      @1 Department of Psychiatry, University of Toronto @3 CAN @Z 6 aut. @Z 8 aut.
A14 07      @1 Department of Pharmacology and Toxicology, University of Toronto @2 Toronto, Ontario @3 CAN @Z 6 aut.
A14 08      @1 Department of Psychiatry, School of Medicine and Graduate School of Public Health, University of Pittsburgh @3 USA @Z 7 aut.
A14 09      @1 Department of Psychiatry Behavioral and Community Health Sciences, School of Medicine and Graduate School of Public Health, University of Pittsburgh @2 Pittsburgh, Pennsylvania @3 USA @Z 7 aut.
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A47 01  1    @0 14-0227293
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A64 01  1    @0 Journal of the American Geriatrics Society
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C01 01    ENG  @0 OBJECTIVES: To examine the association between depression, antidepressant use, and bone health in older adults and the implications for treatment. DESIGN: Systematic review. SETTING: All studies that measured depression or antidepressant exposure and bone mineral density (BMD). PARTICIPANTS: Adults aged 60 and older. MEASUREMENTS: Age, site of BMD measurement using dual-energy X-ray absorptiometry (DXA), measure of depression or depressive symptoms, association between BMD changes, and depression or antidepressant use. RESULTS: Nineteen observational studies met the final inclusion criteria; no experimental studies were found. Several cross-sectional and longitudinal studies found that depression or depressive symptoms were associated with a decrease in BMD. Few studies and only two longitudinal studies addressed the association between serotonin reuptake inhibitor (SRI) antidepressant use and a decrease in BMD and they had conflicting results. CONCLUSION: Depression and depressive symptoms are associated with low bone mass and accelerated bone loss in older adults; putative mechanisms underlying this relationship are discussed. There is insufficient evidence that SRI antidepressants adversely affect bone health. Thus, a change in current recommendations for the use of antidepressants in older adults is not justified at the present time. Given the high public health significance of this question, more studies are required to determine whether (and in whom) antidepressants may be deleterious for bone health.
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C03 02  X  FRE  @0 Antidépresseur @5 03
C03 02  X  ENG  @0 Antidepressant agent @5 03
C03 02  X  SPA  @0 Antidepresor @5 03
C03 03  X  FRE  @0 Pathologie du système ostéoarticulaire @5 05
C03 03  X  ENG  @0 Diseases of the osteoarticular system @5 05
C03 03  X  SPA  @0 Sistema osteoarticular patología @5 05
C03 04  X  FRE  @0 Os @5 06
C03 04  X  ENG  @0 Bone @5 06
C03 04  X  SPA  @0 Hueso @5 06
C03 05  X  FRE  @0 Santé @5 08
C03 05  X  ENG  @0 Health @5 08
C03 05  X  SPA  @0 Salud @5 08
C03 06  X  FRE  @0 Personne âgée @5 09
C03 06  X  ENG  @0 Elderly @5 09
C03 06  X  SPA  @0 Anciano @5 09
C03 07  X  FRE  @0 Revue systématique @2 FM @5 11
C03 07  X  ENG  @0 Systematic review @2 FM @5 11
C03 07  X  SPA  @0 Revisión sistemática @2 FM @5 11
C03 08  X  FRE  @0 Gériatrie @5 12
C03 08  X  ENG  @0 Geriatrics @5 12
C03 08  X  SPA  @0 Geriatría @5 12
C03 09  X  FRE  @0 Gérontologie @5 17
C03 09  X  ENG  @0 Gerontology @5 17
C03 09  X  SPA  @0 Gerontología @5 17
C03 10  X  FRE  @0 Psychotrope @2 FX @5 25
C03 10  X  ENG  @0 Psychotropic @2 FX @5 25
C03 10  X  SPA  @0 Psicotropo @2 FX @5 25
C07 01  X  FRE  @0 Homme
C07 01  X  ENG  @0 Human
C07 01  X  SPA  @0 Hombre
C07 02  X  FRE  @0 Trouble de l'humeur @5 37
C07 02  X  ENG  @0 Mood disorder @5 37
C07 02  X  SPA  @0 Trastorno humor @5 37
C07 03  X  FRE  @0 Système ostéoarticulaire @5 38
C07 03  X  ENG  @0 Osteoarticular system @5 38
C07 03  X  SPA  @0 Sistema osteoarticular @5 38
N21       @1 272
N44 01      @1 OTO
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Le document en format XML

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<div type="abstract" xml:lang="en">OBJECTIVES: To examine the association between depression, antidepressant use, and bone health in older adults and the implications for treatment. DESIGN: Systematic review. SETTING: All studies that measured depression or antidepressant exposure and bone mineral density (BMD). PARTICIPANTS: Adults aged 60 and older. MEASUREMENTS: Age, site of BMD measurement using dual-energy X-ray absorptiometry (DXA), measure of depression or depressive symptoms, association between BMD changes, and depression or antidepressant use. RESULTS: Nineteen observational studies met the final inclusion criteria; no experimental studies were found. Several cross-sectional and longitudinal studies found that depression or depressive symptoms were associated with a decrease in BMD. Few studies and only two longitudinal studies addressed the association between serotonin reuptake inhibitor (SRI) antidepressant use and a decrease in BMD and they had conflicting results. CONCLUSION: Depression and depressive symptoms are associated with low bone mass and accelerated bone loss in older adults; putative mechanisms underlying this relationship are discussed. There is insufficient evidence that SRI antidepressants adversely affect bone health. Thus, a change in current recommendations for the use of antidepressants in older adults is not justified at the present time. Given the high public health significance of this question, more studies are required to determine whether (and in whom) antidepressants may be deleterious for bone health.</div>
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