Influencing factors of mental and bone health status of older women

A total of 576 older women aged more than 75 years old were recruited from 30 communities. Participants completed the Kessler Psychological Distress Scale (K10). Participants’ bone mineral density was measured by ultrasound bone densitometer or dual energy X-ray absorptiometry.

Results

The average K10 score was (14.78±4.23). There were 352 subjects (61.11%) in “good” mental health status, 158(27.43%) in general status and 66(11.46%) in poor status. There were 315 older women(54.69%) who developed OP, and they had significantly higher K10 score than the non-OP subjects. A Multivariate Logistic Regression analysis showed that poor mental status, aging, age at menarche <16 years, long time of menopause, more delivery times were the risk factors for OP in older women, while regular exercise and high BMI were the protective factors against OP in older women. Pearson Correlation Coefficient analysis showed that bone mineral density was negatively correlated with K10 score.

Conclusion

Mental and bone health of older women are affected by a variety of factors. Clinical care can focus on providing comprehensive prevention and control of these factors.

Keywords:
older women; Kessler Psychological Distress Scale; mental health status; bone health; osteoporosis; cross-sectional study

Index		Cases	K10 score	t/F	P
Age (years)	<80	265	14.34±2.16	6.737	0.000
	80-89	233	14.82±2.53
	>90	78	15.74±3.37
Spouse (with/without)	Yes	373	14.23±2.26	0.687	0.493
Spouse (with/without)	No	203	14.39±2.87	0.687	0.493
Education level	Literate	179	15.34±3.61	7.334	0.000
	Junior high school or below	229	14.21±3.45
	High school or above	168	13.76±2.38
Living alone	Yes	178	17.23±4.42	8.365	0.000
Living alone	No	398	14.23±2.74	8.365	0.000
Salary (RMB)	<1,000	30	17.92±4.45	5.332	0.000
	1,000-2,000	148	15.64±3.32
	2,000-3,000	278	13.19±3.05
	>3,000	120	12.07±2.01
Ability of daily living	No Problem	405	12.56±2.34	5.345	0.000
	Having some problem	122	14.32±2.73
	Unable to participant in daily activities	49	16.78±4.29
Filial piety	Satisfied	339	12.32±1.92	16.385	0.000
Filial piety	Not satisfied	237	16.37±3.45	16.385	0.000
Diseases	Yes	369	16.93±4.33	16.385	0.000
Diseases	No	207	13.38±3.56	16.385	0.000
Sleep quality	Good	206	13.76±2.53	12.568	0.000
	Not bad	214	15.23±2.87
	Poor	156	16.23±3.13
Osteoporosis	Yes	315	15.78±4.22	6.918	0.000
Osteoporosis	No	261	13.65±3.16	6.918	0.000
Regular exercise	Yes	335	13.23±2.09	8.145	0.000
Regular exercise	No	241	15.34±3.61	8.145	0.000
Subjective well-being	Yes	415	12.54±2.19	11.424	0.000
Subjective well-being	No	161	15.32±2.77	11.424	0.000
Sense of loneliness	Yes	228	15.23±3.21	12.857	0.000
Sense of loneliness	No	348	12.15±2.06	12.857	0.000

Index	β	S.E	Wald χ²	P	OR	95% CI
Education level	0.617	0.245	3.447	0.004	5.325	4.927-7.316
Living condition	0.458	0.316	5.016	0.005	4.027	3.115-9.641
Salary	0.632	0.216	9.241	0.000	12.123	11.334-32.396
Ability of daily living	0.431	0.272	6.732	0.000	9.626	7.834-17.483
Filial piety	0.427	0.124	11.675	0.000	1.456	1.176-3.663
Diseases	0.480	0.107	20.466	0.000	1.615	1.273-4.687
Regular exercise	0.412	0.213	6.847	0.000	11.678	9.427-19.365
Sleep quality	0.581	0.352	6.718	0.000	9.623	7.811-16.473
Subjective well-being	0.898	0.109	7.376	0.000	2.463	1.687-3.109
Loneliness	0.452	0.217	5.915	0.000	8.934	6.292-15.356
Osteoporosis	0.762	0.263	4.375	0.013	6.782	5.327-10.629

Index	Quantification and assignment
Index	1	2	3	4
Education level	High school or above	Junior high school or below	Literate
Living condition	Other	Living alone
Salary (RMB)	>3,000	2,000-3,000	1,000-2,000	<1,000
Ability of daily living	No problem	Having some problems	Unable to participant in daily activities
Filial piety	Satisfied	Not satisfied
Diseases (Yes or no)	No	Yes
Regular exercise (Yes or no)	Yes	No
Sleep quality	Good	Not bad	Poor
Subjective well-being (Yes or no)	Yes	No
Sense of loneliness (Yes or no)	No	Yes
OP (Yes or no)	No	Yes

Index	Cases	Women with OP	Prevalence of OP	χ²	P
Age at Menarche (years)				11.383	0.000
<16	466	239	51.29
≥16	110	76	69.09
BMI (kg/m²)				28.839	0.000
<18.5	156	112	71.79
18.5-24	218	115	52.75
≥24	202	88	43.56
Delivery times				20.993	0.000
1	118	50	42.37
2	185	89	48.11
≥3	273	176	64.47
Pregnancy times				12.106	0.002
1	83	35	42.17
2	203	102	50.25
≥3	290	178	61.38
Regular exercise				87.737	0.000
Yes	335	128	38.21
No	241	187	77.59
Mental status				23.274	0.000
Good	352	169	48.01
Not bad	158	94	59.49
Relatively poor or poor	66	52	78.79

Index	β	S.E	Wald χ²	P	OR	95% CI
Age (years)	0.616	0.307	3.841	0.004	1.853	1.783-6.325
Duration of menopause (years)	0.787	0.229	12.393	0.000	2.193	2.011-7.342
Age at Menarche (years)	1.023	0.226	19.633	0.000	2.327	1.128-6.630
BMI	-0.665	0.272	8.312	0.003	0.578	0.353-0.855
Delivery times	0.376	0.127	9.653	0.002	1.445	1.227-6.619
Regular exercise	-0.734	0.261	7.878	0.004	0.488	0.338-0.714
Mental status	0.487	0.188	6.754	0.004	1.622	1.129-3.256

Index	Quantification and assignment
Index	1	2	3
Age (years)	<80	80-89	>90
Duration of menopause (years)	10-19	20-29	≥30
Age at Menarche (years)	≥16	<16
BMI	<18.5	18.5-24	≥24
Delivery times	1	2	≥3
Pregnancy times	1	2	≥3
Regular exercises (Yes or no)	Yes	No
Mental status	Good	Fair	Relatively poor or poor

K10 score	n	BMD value (G/cm²)	T value	Women with OP	Prevalence of OP (%)
10-15	352	0.347 (0.283; 0.441)	-2.200 (-2.632, -1.145)	169	48.01
16-21	158	0.312 (0.258; 0.415)	-2.870 (-3.526, -1.574)	94	59.49
22-50	66	0.269 (0.204; 0.344)	-3.400 (-3.883, -2.652)	52	78.79
Total	576	0.320 (0.254, 0.437)	-2.600 (-3.357, -1.422)	315	54.69

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[1] *Corresponding author: drhongrong@outlook.com