Happy Life, Happy Bones?

Megan Brooks

January 15, 2015

Older women who are satisfied with their lives have higher bone density than their unsatisfied peers, a finding that adds weight to the idea that psychological health influences physical health.

Päivi Rauma

"Osteoporosis is a common disease which easily leads to bone fracture, and hip fractures in particular can have serious consequences with long-term hospitalizations and decreased health," lead investigator Päivi Rauma, of the Bone and Cartilage Research Unit, University of Eastern Finland, in Kuopio, told Medscape Medical News.

"While life satisfaction is beneficial for overall health, focusing on subjective well-being and promoting life satisfaction can be one of the approaches that should be considered in order to decrease the adverse effect of aging on bone," Rauma said.

The study was published in the November/December 2014 issue of Psychosomatic Medicine.

Don't Worry, Be Happy

The findings stem from the ongoing Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) Study, initiated in 1989 to investigate the effects of various risk and protective factors on bone health and bone fractures.

The analysis included 2167 women who underwent femoral bone mineral density (BMD) assessment in 1999, of whom 1147 took part in follow-up assessment 10 years later, in 2009. The researchers gauged life satisfaction via a 4-point scale relating to interest in and easiness of life, happiness, and loneliness. On the basis of responses, the women were divided into a satisfied group, a middle group, and an unsatisfied group.

At baseline, the satisfied group had the highest BMD, whereas dissatisfied women had the highest body mass index, the lowest grip strength, and were more likely to be smokers. The dissatisfied group also had higher morbidity and used more medications than the other two groups.

During a period of 10 years, average femoral BMD decreased from 880 to 846 mg/cm2. In the multivariate model, life satisfaction (P = .028) and improvement in life satisfaction (P = .001) predicted reduced bone loss, whereas hospital stay due to depression predicted increased bone loss (P = .014), the researchers report.

During the 10 years, mean bone density of all women weakened by 4%; however, the difference in mean BMD between the satisfied and the unsatisfied women was as much as 52%, Rauma noted.

"Changes in life satisfaction during the follow-up also affected bone density. In persons whose life satisfaction deteriorated, bone density decreased by 85% in comparison to persons whose life satisfaction improved," she said.

Novel Study

"The mechanisms of action in the relationship between life dissatisfaction and bone loss are still unclear," Rauma said. "The suggested method in depression is chronic stress, which stimulates cortisol and catecholamine secretion, resulting in bone loss. Also, increased levels of bone resorption markers and proinflammatory cytokines have been found in depression. Similar biological factors and mechanisms probably play a role in the relationship between life dissatisfaction and bone loss, but more research is needed."

Commenting on the findings for Medscape Medical News, Laura Kubzansky, PhD, MPH, professor, Department of Social and Behavioral Sciences, Harvard School of Public Health, in Boston, Massachusetts, and member of the American Psychological Association, said the study adds to a growing body of evidence supporting the link between psychological and physical health.

"The extent to which positive psychological functioning can influence a range of physical health outcomes is only just beginning to be looked at. Much of the strongest evidence that there is an effect is in the domain of cardiovascular disease."

"What seems novel here is looking at an outcome that has not been considered explicitly in other studies. The study adds to the evidence base that is emerging to suggest that psychological factors truly [influence] physical health and suggests it may be across a wider spectrum of outcomes than has previously been appreciated," Dr Kubzansky said.

The authors and Dr Kubzansky report no relevant financial relationships.

Psychosom Med. 2014; 76:709-715. Abstract

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