A comprehensive review and meta-analysis published in Translational Psychiatry has affirmed that individuals with schizophrenia have more fragile bones than those without the disorder, which carries an increased risk of fractures.
“Our findings regarding poor bone health in people with schizophrenia are concerning, given previous studies have indicated that this population experiences more adverse events following a fracture event, including longer length of hospitalization, higher risk of adverse perioperative events and acute post-operative complications, and in turn increased healthcare costs,” wrote Behnaz Azimi Manavi, Ph.D., of Deakin University in Geelong, Australia, and colleagues. “[I]t is not unrealistic to suggest that poorer outcomes associated with bone fragility contribute to the higher mortality rate in this population.”
Manavi and colleagues examined data from 29 studies that compared markers of osteoporosis in adults with schizophrenia with those of adults without the disorder; this included studies assessing bone mineral density, bone quality (strength and stiffness), bone turnover (the rate new bone is laid down and old bone removed), and/or risk of fracture. The studies encompassed 52,246 adults with schizophrenia along with over 4 million control individuals.
In total, the study data indicated that adults with schizophrenia have lower bone density (particularly at the hip), poorer bone quality, and higher rates of bone turnover; no significant differences between males and females were identified. A meta-analysis of seven studies that included fracture data found that adults with schizophrenia have a 32% increased risk of fracture, after adjusting for potential biases, again with no risk difference between males and females.
Manavi and colleagues noted that since schizophrenia is associated with premature mortality and the risks of osteoporosis increase with age, their findings may underestimate the true burden of schizophrenia on bone health in older adults.
“Further research is needed to evaluate the etiology of bone fragility in this population and recognize modifiable risk factors such as lifestyle or medications to reduce the potential risk for this patient group. Importantly, there is a need to develop guidelines for preventing risk factors and predicting fracture in people with schizophrenia,” they concluded.
For related information, see the Psychiatric News article “Study Calculates Disability Caused by Schizophrenia.”
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