Screening with the PHQ-9 and WHOQOL-BREF in community-based NCD camps may help in the early identification of depressive symptoms among menopausal women with osteoporosis.
Abstract
Depression is an under-recognized risk factor for osteoporosis (OP) and adversely affects quality of life (QOL). Data on depressive symptoms among postmenopausal women aged ≥50 years with osteoporosis in India are limited. This study aimed to assess depressive symptoms and their impact on QOL among postmenopausal women with osteoporosis from low- and middle-income urban communities.
A total of 688 menopausal women aged ≥50 years were recruited through community-based camps (2016–2019), of whom 14.2%, 31.5%, and 54.2% were diagnosed as normal, osteopenia, and osteoporosis, respectively, by dual-energy X-ray absorptiometry (DXA) scans. A subset of 100 postmenopausal women aged 50–75 years with osteoporosis and ≥5 years since menopause was included using a consecutive convenience sampling technique. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and QOL was assessed using the WHOQOL-BREF through face- to- face (in-person) interviews. Participants were also assessed for non-communicable diseases (NCD) and musculoskeletal complaints.
Mild, moderate, and moderately severe depressive symptoms were observed in 17%, 4%, and 1% of the participants, respectively. The comparison of WHOQOL-BREF with depressive symptoms revealed that the physical domain of WHOQOL was significantly associated with depressive symptoms, indicating that women with depressive symptoms had substantially lower median scores [63.0 (IQR:50.0-69.0) vs. 88.0 (IQR: 81.0-94.0), Mann-Whitney U=128.0, z= -6.136,
p
<0.001, r=0.61].
Screening with the PHQ-9 and WHOQOL-BREF in community-based NCD camps may help in the early identification of depressive symptoms among menopausal women with osteoporosis. Integrating mental health screening with current geriatric and primary healthcare services through national initiatives, such as the National Mental Health Programme and Ayushman Bharat, may improve the overall quality of life.
Objective:
This study aimed to assess quality of life (QoL) and identify its predictors among postmenopausal women with osteoporosis attending outpatient clinics at Prince Sultan Military Medical City (PSMMC), Riyadh.
Methods:
This cross-sectional observational study enrolled 357 postmenopausal women with DXA confirmed osteoporosis. Data were collected through structured interviews using the Arabic-validated version of the WHOQOL-BREF questionnaire and a sociodemographic and clinical data form.
Results:
The overall QoL was moderate with the median overall QoL score (Q1) was 75.0 (IQR ≤ 25.0), and the median general health satisfaction score (Q2) was 75.0 (IQR ≤ 50.0). At the domain level, social relationships had the highest median score (75.0), and physical health had the lowest (50.0), reflecting the preferential physical burden of osteoporosis in this population. Women with a history of fragility fracture had significantly lower QoL in five of six domains (physical health, psychological, environment, overall QoL, and general health; all p < 0.001). Education was the strongest group-level predictor across all domains (H ≤ 47â"146, all p < 0.001). Spearman correlations identified income as the strongest single correlate (r ≤ 0.704 with Environment, p < 0.001). Across all six regression models, age was the most consistent independent negative predictor (all p < 0.001), while education, income, lumbar spine T-score, and fracture history were the most consistent significant predictors.
Conclusion:
Overall, postmenopausal women with osteoporosis at PSMMC reported a moderate global QoL. QoL was found to be shaped by a combination of modifiable socioeconomic factors and non-modifiable clinical factors.
Nouf Almehmadi, Safa Alsedrah· International Journal of Med...· 0 citations
Purpose: Psychosocial factors are underexplored in relation to osteoporosis. This study examined whether depressive symptoms are associated with incident osteoporosis in middle aged and older adults, and whether this association is modified by age or sex. Methods: Prospective cohort study of 8,577 adults aged [≥]50 years from the English Longitudinal Study of Ageing. The sample were free of osteoporosis at baseline (2002-2003) and were followed up for incident osteoporosis until wave 11 (2023-2024). Depressive symptoms were measured at baseline (2002-03) using the 8-item Center for Epidemiologic Studies-Depression Scale (CES-D). Cox proportional hazards regressions were used to estimate associations, adjusting for age, sex and wealth. Results: Over 20 years of follow-up, 948 (11.1%) participants reported incident osteoporosis. Each one-point increase in baseline CES-D was associated with a higher hazard of incident osteoporosis adjusted for age, sex, and wealth (hazard ratio (HR) 1.07, 95% CI 1.04-1.11, p<0.001). The association was modified by age (interaction p=0.008) and concentrated in participants aged 50-64 years at baseline (HR 1.10, 95% CI 1.06-1.14), with no significant association in older age strata. Osteoporosis incidence was higher in women, but this was not modified by depressive symptoms. Findings were robust to sequential adjustment (informed by a directed acyclic graph) for education, wealth, inflammatory conditions and health behaviours (HR 1.04, 95% CI 1.01-1.08) Conclusion: Depressive symptoms are associated with incident osteoporosis over two decades of follow-up, particularly among adults aged 50-64. Mid-life may represent a target for psychosocial intervention to support bone health.
R. A. Hackett, J. Galloway, M. Russell et al.· medRxiv· 0 citations
Menopause is a natural biological transition that may substantially influence women's physical, psychological, and social well-being. This study examined quality of life and factors associated with menopause among middle-aged women in West Java, Indonesia. An analytic cross-sectional study was conducted involving 210 women aged 45–60 years who were perimenopausal or postmenopausal. Data were collected using a structured questionnaire incorporating the Menopause-Specific Quality of Life (MENQOL) instrument, along with assessments of sociodemographic characteristics, lifestyle, health conditions, sleep quality, and stress levels. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression (p < 0.05). Most participants reported moderate to poor quality of life, with the physical domain recording the highest mean score (4.87 ± 1.34). Poor quality of life was significantly associated with obesity (p = 0.002), low physical activity (p = 0.001), chronic disease (p = 0.000), poor sleep quality (p = 0.000), high stress levels (p = 0.000), and cigarette smoke exposure (p = 0.031). Multivariate analysis identified high stress as the strongest predictor of poor quality of life (AOR = 4.27; 95% CI: 2.11–8.65), followed by poor sleep quality (AOR = 3.84; 95% CI: 1.92–7.68). These findings indicate that menopause-related quality of life is influenced by multidimensional factors, particularly psychological and lifestyle determinants. Comprehensive and culturally sensitive interventions are needed to promote well-being and healthy aging among menopausal women.
Sri Hayati, Umi Khasanah· Media of Health Research· 0 citations
Background and Objectives: Anxiety and depression are among the most common psychological symptoms in patients with cancer and are associated with morbidity and impaired health-related quality of life (HRQoL), independent of the cancer stage. This study aimed to determine the prevalence of clinically significant anxiety and depression among adult oncology patients in Iraq and quantify the independent contribution of these symptoms to HRQoL. Materials and Methods: A cross-sectional study was conducted between 1 November and 15 December 2024, at the National Oncology Hospital in Najaf, Iraq. A total of 200 adult oncology patients were enrolled using consecutive sampling. Symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), and HRQoL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G). Descriptive statistics were used to summarize sample characteristics. Group comparisons were performed using Pearson’s chi-square test, the Fisher–Freeman–Halton exact test with Monte Carlo estimation, and one-way ANOVA, as appropriate. Associations among continuous variables were assessed using Pearson’s correlation and multiple linear regression. Statistical significance was set at p < 0.05. Results: The mean age (SD) was 52.2 (12.0) years, and 64.0% of the participants were male. Severe anxiety and severe depression were observed in 41.0% and 34.0% of the participants, respectively. Anxiety severity was significantly associated with age, sex, marital status, and treatment modality (all p < 0.01) and was significantly higher in females (58.3% vs. 31.2%) and unmarried patients. Depression severity was significantly associated with age (p = 0.005), sex (p < 0.001), and marital status (p < 0.001) but not with cancer stage (p = 0.223) or treatment modality (p = 0.530). The mean total FACT-G score was 58.2 (14.6), indicating low-to-moderate HRQoL. HADS-A and HADS-D were strongly intercorrelated (r = 0.741) and inversely correlated with FACT-G (r = −0.750 and r = −0.780, respectively; all p < 0.001). Multiple linear regression showed that higher HADS-A and HADS-D scores were independently associated with lower HRQoL, and the full seven-predictor model explained approximately 62% of the variance in FACT-G total scores (R2 = 0.62). Conclusions: Severe anxiety and severe depression were observed in 41.0% and 34.0% of participants, respectively. Higher anxiety and depression scores were independently associated with lower HRQoL.
A. Alkhaqani, Miklós Sugár, A. Jaber et al.· Medicina· 0 citations
Introduction Menopause is a natural life stage often accompanied by persistent symptoms, such as hot flushes, night sweats, and mood changes that can significantly affect quality of life. While symptom experiences vary across cultures, little is known about menopause-related quality of life among Qatari women. The objective of this study was to measure the association between menopause symptoms and the quality of life of Qatari women. Methods An online, self-administered cross-sectional survey was distributed to all Qatari women aged 30-64 attending Primary Health Care Corporation Centers in Qatar for any reason. Results A total of 512 women completed the Menopause-Specific Quality of Life questionnaire. The mean (SD) age of respondents was 48.8 (7.28) years, with a median of 50 years. Mean (SD) age at menopause was 48.83 (4.93) years. The most frequently experienced symptoms were feeling tired (88.0%), aching muscles/joints (87.0%), lacking energy (86.0%), decreased physical strength (84.0%), low backache (82.0%) and flatulence (80.9%). Menopause status was significantly related to hot flushes (p< 0.001), night sweats (p< 0.001), accomplishing less (p=0.042), aching muscles/joints (p=0.041), aching back/neck/head (p=0.011), decreased physical strength (p=0.028), vaginal dryness during intimacy (p=0.001), and avoiding intimacy (p=0.002). Psychosocial symptoms were reported by 63.2% of respondents, followed by vasomotor symptoms (66.3%), sexual symptoms (66.4%), and physical symptoms (75.9%). There were statistically significant differences in mean scores of vasomotor, physical, and sexual domains across the menopause groups. Conclusion Qatari women experience the onset of menopause at a younger age compared to women from other Arab and high income countries and are mostly bothered by symptoms related to physical discomfort and fatigue. Qatari women experience a high quality of life in the psychosocial domain. To improve care, health systems should prioritize menopause awareness and education, develop culturally sensitive strategies, and integrate these into primary care to enhance the wellbeing of aging women.
Qasim M Al-Shboul, M. Sendall, Lily O'Hara et al.· Inquiry : a journal of medic...· 0 citations
Introduction Endometriosis is a chronic disease associated with pain, fertility difficulties, and reduced quality of life (QoL). Beyond clinical symptoms, health-related and lifestyle behaviors may influence the long-term impact of the disease. This study aimed to assess multiple QoL dimensions in women with endometriosis and examine their associations with disease-related symptoms, body mass index (BMI), and lifestyle characteristics. Methods A cross-sectional online survey was completed by 153 women aged ≥ 18 years with self-reported endometriosis. Data included sociodemographic characteristics, body weight, physical activity, diet, smoking, and digestive symptoms, including painful defecation. The Endometriosis Impact Questionnaire evaluated physical, psychological, social, sexual and intimate, fertility, educational, employment and financial, and lifestyle QoL across three recall periods. Non-parametric tests and multivariate linear regression models assessed group differences and factors associated with QoL dimensions and overall impact. Results The greatest burden was observed in fertility, physical, and psychological dimensions, particularly during the previous 12 months. Body-weight change since symptom onset was associated with poorer outcomes across all QoL domains. BMI showed coding-dependent associations: continuous BMI predicted greater physical and psychological impact, whereas BMI ≥ 25.0 kg/m2 was linked to lower impact in physical (β=−0.42; p = 0.005), sexual and intimate (β=−0.31; p = 0.044), and employment and financial QoL (β=−0.31; p = 0.049). Painful defecation was associated with greater psychological and sexual and intimate impact and higher overall impact. Smoking was associated with greater lifestyle impact (β=0.38; p < 0.001) and higher overall impact (β=0.17; p = 0.042). Dietary supplement use was associated with lower fertility impact (β=−0.18; p = 0.049), whereas following a dietary regimen was associated with higher fertility impact (β=0.22; p = 0.014). Conclusion Endometriosis substantially affects multiple life domains, particularly fertility and physical and psychological well-being. Weight change, painful defecation, and smoking were linked to poorer QoL, while BMI demonstrated complex domain-specific associations. Integrated medical and lifestyle approaches may improve long-term disease impact.
Marijana Matek Sarić, Marija Ljubičić, Tamara Sorić et al.· Frontiers in Global Women's...· 0 citations
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