Association between mental health and bone mass among community-dwelling adults: Nagasaki Islands Study on bone health

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  • Okawachi Tetsuji
    Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences
  • Arima Kazuhiko
    Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences
  • Mizukami Satoshi
    Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences
  • Koto Serina
    Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences
  • Suiko Masahiro
    Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences
  • Kit Ayano
    Department of Nursing, Kyoto Koka Women’s University
  • Nakashima Hiroki
    Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences
  • Uchiyama Michiko
    Department of Orthopedic Surgery, Nagasaki Rosai Hospital
  • Honda Yuzo
    Department of Orthopedic Surgery, Isahaya General Hospital
  • Tanaka Natsumi
    Department of Orthopedic Surgery, Nagasaki Rosai Hospital
  • Tsujimoto Ritsu
    Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • Nishimura Takayuki
    Department of Human Life Design, Faculty of Design, Kyushu University
  • Tomita Yoshihito
    School of Rehabilitation, Department of Physical Therapy, Tokyo Professional University of Health Sciences
  • Abe Yasuyo
    Department of Health and Nutrition, Nishikyusyu University
  • Kusano Yosuke
    Department of Nursing, Nishikyusyu University
  • Kawashiri Shin-Ya
    Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences
  • Tamai Mami
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences
  • Yamanashi Hirotomo
    Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
  • Nagata Yasuhiro
    Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Kawakami Atsushi
    Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences
  • Maeda Takahiro
    Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Aoyagi Kiyoshi
    Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences

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Osteoporosis and its related fractures are important public health issues. This study examined the association between the Kessler Psychological Distress Scale (K6) and low bone mass in middle-aged community-dwelling men and women. A cross sectional study was nested in a prospective observational study of 1,101 participants (median age: 57 [49-62] years in men and 58 [50-62] years in women) residing in a rural city in western Japan. Participants were recruited during medical check-ups in 2016 and 2017 from the community-dwelling population. The bone mass of the calcaneus was evaluated using quantitative ultrasound. Of the participants, 56 men (14.9%) and 144 women (19.9%) had a bone mass of less than 70% of the mean of young adults. Univariate analysis revealed that there was a trend toward lower body mass index (BMI) and higher prevalence of low bone mass with an increase in K6 scores in men but not in women. Logistic regression analysis, adjusting for possible confounders (age, BMI, smoking, drinking habits, exercise habits, diabetes, hyperlipidemia, and hypertension), showed significant associations between the K6 scores and low bone mass (odds ratio (OR) = 2.66 for the men with 5 to 12 points of K6, OR = 7.51 for men with ≥ 13 of K6, not for women). We showed an association between psychological distress and low bone mass independent of cofounders among community-dwelling middle-aged men but not women. This suggests that healthy mental health in middle-aged men may be a possible target for the prevention of consequent osteoporosis or fragile bone fractures.

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