Korean J Fam Pract 2019; 9(3): 277-283  https://doi.org/10.21215/kjfp.2019.9.3.277
The Impact of Depression on Fracture in Elderly: A Nationwide Population-Based Retrospective-Cohort Study
Yu Mee Lee1, Mee Young Kim1,*, Jong Lull Yoon1, Jung Jin Cho1, Young Soo Ju2
1Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong;
2Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
Mee Young Kim
Tel: +82-31-8086-3790, Fax: +82-31-8086-2709
E-mail: doctorkmy@hallym.or.kr
Received: August 13, 2018; Revised: October 13, 2018; Accepted: October 28, 2018; Published online: June 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Fractures should be actively prevented in the elderly because recovery from the damage of fractures is slow and fractures can cause both physical and psychological pain in the elderly. Previous studies have reported that depression is related to falls or low bone mineral density (BMD). This study aimed to evaluate the risk of fracture according to the depression status among the elderly.
Methods: This study used the National Health Insurance Corporation cohort data to examine 96,188 elderly people aged >65 years who were examined in 2007 and 2008. The chi-square test was used to determine the general characteristics and fracture incidence in patients with depression and healthy controls, and the hazard ratio was calculated using the Cox proportional hazards model corrected for general characteristics. The Kaplan-Meier method predicted the risk of fracture in two groups during the observation period.
Results: In the depressed group, 23.2% (441 of 1,904) of the patients had a fracture during the 5-year follow-up period; however, in the control group, only 17.5% (16,470 of 94,284) had a fracture (P<0.001). In addition, multivariate analysis of the adjusted variables showed that the risk of fracture in the depressed group was 1.34 times higher than that in the control group. The risk of fracture in women was 1.71 times higher than that in men, and the risk of fracture increased with age.
Conclusion: The risk of fracture in the elderly who were depressed was significantly higher than that in the elderly who were not depressed.
Keywords: Depression; Depressive Disorder; Fracture; Aged
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