A Brief Note On Osteoporosis And Its Effects

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Introduction
Osteoporosis is a chronic skeletal disease resulting from deterioration in micro-architecture marked by general impairment of bone mass and a consequent decline in bone strength (1, 2). This manifests as an increase in the propensity to fragility fractures of the vertebrae, wrist, hip and other skeletal sites. Fractures as a result of fragility lead to increasing morbidity and consequently mortality in this population (3). It may also impair mobility, resulting in decreased quality of life and significant social and financial burden (4, 5).
Osteoporosis is often associated with depression, also a high prevalent, chronic and debilitating disorder, characterized by decreased mood, impaired cognitive functioning, and low energy
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The aim of this article is to summarize the evidence regarding the effects of serotonergic antidepressants on bone density and its implications for clinical care.

Depression, bone mineral density, and fractures
Several reports support the notion that depression may cause bone deterioration and consequently increase the risk of osteoporotic fractures in adults, including three meta-analyses, which provides evidence of an association between depression and low BMD (10-20). Even after adjustment for known risk factors for osteoporosis, BMD remains negatively associated with the presence of depressive symptoms in older subjects (21). There is further some evidence suggesting that decreased BMD occurs at the beginning of depression, and not just as a final consequence (22). A recent meta-analysis on the topic specified that depressed individuals display lower BMD at the spine, hip and forearm, with a stronger association observed for pre-menopausal than for post-menopausal women, probably due to the fact that post-menopausal women present other risk factors for osteoporosis, such as lower estrogen levels and physical inactivity, thus hampering the association (17). The same results were replicated in a meta-analysis conducted by Wu et al., which showed decreased BMD at the spine and hip for subjects with depression when compared to
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