Social Stress Linked to Bone Loss in Postmenopausal Women

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High social stress was associated with decreased bone mineral density over 6 years of follow-up.

High levels of social stress are associated with greater bone loss in postmenopausal women, according to study results published in the Journal of Epidemiology & Community Health.

The study included postmenopausal women from 40 clinical centers throughout the United States who were enrolled in the Women’s Health Initiative cohort (n=8271). Participants completed questionnaires at baseline to assess social stress. The researchers used linear regression models to examine associations between social measures of psychological stress (social strain, social functioning, and social support) and percent change in bone mineral density (BMD) over 6 years.

Participants with high social strain were more likely to be younger, have higher body mass index, and were more often smokers compared with women with low social strain. Women with low social stress reported more education and physical activity compared with those with high social strain. Additionally, black, Latina, and Native American women reported higher levels of social strain compared with white and Asian women.

High social stress was associated with decreased BMD over 6 years of follow-up. After adjusting for confounders, the researchers found that with each single point increase in social strain score, participants had a 0.082% greater loss of femoral neck BMD, 0.108% greater loss of total hip BMD, and 0.069% greater loss of lumbar spine BMD (P <.05).

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Over the 6 years, both low social functioning and low social support were associated with greater decreases in femoral neck BMD. Low social functioning was also associated with greater decreases in total hip BMD.

“This research helps to elucidate the complex role of psychosocial stress in BMD among postmenopausal women towards the identification of specific patient groups that would benefit more from targeted [behavioral] prevention strategies,” the researchers wrote.

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Follis SL, Bea J, Klimentidis Y, et al. Psychosocial stress and bone loss among postmenopausal women: results from the Women’s Health Initiative [published online July 9, 2019]. J Epidemiol Community Health. doi:10.1136/jech-2019-212516