Anxiety levels predict low bone mineral density in postmenopausal women assessed for osteoporosis.

Introduction.– Anxiety may be observed as a consequence of several chronic diseases, but the effects of anxiety levels per se on bone health in postmenopausal women are poorly investigated. Objective.– To investigate the impact of anxiety severity on bone mineral density (BMD) and prevalent vertebral fractures in a set of ambulatory care Caucasian women referred for osteoporosis. Methods.– Hamilton Anxiety Rating Scale(HAMA)for anxiety levels, Beck Depression Inventory for depressive symptoms and the 36- Item Short Form Health Survey (SF-36) for quality of life, in addition to multiple clinical risk factors (CRFs) for fractures and FRAX score, dual-energy X-ray absorptiometry for BMD measurement at lumbar spine and femoral neck, X-ray vertebral morphometry, were evaluated. Results.– Of the 192 recruited women (mean age 67.5±9.5 yr), patients allocated in the tertile of lower HAMA score (HAMA-1) showed lower probability of fracture compared with patients in the highest one (HAMA-3) (20.44±9.3 vs. 24.94±13 SD; P = 0.01). Women in HAMA-3 exhibited lower T-score values at lumbar spine in comparison with women in HAMA-1 (−2.84±1.4 vs. −2.06±1.2 SD, respectively, P < 0.001), and lower T-score values at femoral neck (−2.21±0.9 vs. −1.93±0.6 SD; P < 0.05); lower T-score values were observed inHAMA-3compared with HAMA-2.Ahigher rate of prevalent vertebral fractures were observed in HAMA-3 vs. HAMA- 1. Anxiety levels were significantly related with age, menopausal age, years since menopause and depressive symptoms, and at a multiple regression analysis were predictive of reduced BMD. Conclusions.– Anxiety levels were associated with BMD at both lumbar spine and femoral neck.