{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:03:07Z","timestamp":1759104187576,"version":"3.44.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"38","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9,19]]},"abstract":"<jats:p>To explore the link between depressive symptoms and fracture in midlife women, this study employed both cross-sectional and retrospective cohort analyses, a crucial step in identifying those at risk of fractures. The cross-section study data (n\u2005=\u20051940) were retrieved from the baseline assessment of the Study of Women\u2019s Health Across the Nation. In the retrospective cohort study (n\u2005=\u20051884), women\u2019s Center for Epidemiologic Studies Depression scores were assessed at the start, and their fracture status was recorded during a 5-year follow-up. Logistic regression models were applied to explore the connections between depressive symptoms and fractures in both cross-sectional and retrospective cohort studies. Among 379 women with fracture and 1561 without, depression could not predict fracture based on both Center for Epidemiologic Studies Depression scores (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.216) and depressive symptoms (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.883) after adjusting for age, body mass index, smoking, menopausal status, spine and hip bone mineral density, race\/ethnicity, total family income, education, physical activity, financial strain, medication use, and history of diseases. However, among 1884 women in the retrospective cohort study, depressive symptoms was associated with a 53.6% increase in fracture risk after adjustment (odds ratio 1.536, 95% confidence interval 1.051\u20132.245, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.027). Moreover, a high proportion of women with depressive symptoms was found in the fracture group, and women with depressive symptoms at the start showed a statistically significant correlation with the number of fractures. Depressive symptoms can serve as a predictor for fractures in midlife women 5 years later, independent of health and physiological factors, yet no clear link was found in the cross-sectional analysis.<\/jats:p>","DOI":"10.1097\/md.0000000000044643","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T21:03:11Z","timestamp":1758574991000},"page":"e44643","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Associations of depressive symptoms with fracture in midlife women: An observational study from the Study of Women\u2019s Health Across the Nation"],"prefix":"10.1097","volume":"104","author":[{"given":"Wenjie","family":"Lou","sequence":"first","affiliation":[{"name":"Department of Orthopedics, General Hospital of the Yangtze River Shipping and Wuhan Brain Hospital, Wuhan, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ni","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, General Hospital of the Yangtze River Shipping and Wuhan Brain Hospital, Wuhan, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, General Hospital of the Yangtze River Shipping and Wuhan Brain Hospital, Wuhan, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, General Hospital of the Yangtze River Shipping and Wuhan Brain Hospital, Wuhan, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7471-6544","authenticated-orcid":false,"given":"Biao","family":"Che","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, General 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