| Abstract |
Introduction: Dual-Energy X-Ray Absorptiometry (DXA) is a test that uses X-rays to determine bone mass. Common risk factors for osteoporosis are genetic predisposition, ethnicity/race, advanced age, smoking, alcohol consumption, lack of exercise, poor dietary habits, fracture, calcium imbalances, and many other unknown factors.
Aim: Aim of this study is the investigation of the psychological and psychosocial factors, as well as the social determinants related to the results in bone density measurements.
Methods: The present cross-sectional observational study was conducted at the Health Center located in Heraklion, Crete, which is an urban health center. The study started in February 2023 and lasted 2 months. The population of interest was all adult visitors (women and men) who came to the Radiodiagnostic laboratory, in the Bone Densitometry department of the health center, by appointment. No exclusion criteria were set, only the above characteristics as inclusion criteria. Sampling was opportunistic (non-probability) and the sample was 260 people. A questionnaire was used to collect demographic data and a second to collect participants' medical history and habits. Anxiety was measured using the Short Anxiety Screening Test and loneliness was measured using the UCLA Loneliness Scale. Results: Regarding the psychosocial factors, anxiety (median=21, IQR = 7) and loneliness (median=36, IQR = 9) were found at medium levels in both cases. Additionally, the median BMD in the sample was 0.795 (IQR=0.144), which translates to 13.1% (n=34) of participants having BMD within normal levels, 41.5% (n=108) ranged in the levels of osteopenia, while 40.4% (n=105) had osteoporosis. 21.4% of men had normal T-score levels, 64.3% had osteopenia and 14.3% osteoporosis. 13.3% of women were at normal levels, 42.5% in osteopenic levels and 44.2% in osteoporosis levels. A statistically significant weak positive correlation was found between the SAST and the Loneliness Scale (Spearman's rho = 0.242, P value < 0.001). However, no significant correlation with BMD was found. From the correlations between SAST, Loneliness Scale and Lumbar T-score, no statistically significant correlation was found. Furthermore, the majority of participants with a good appetite experienced osteopenia (45.8%), while the highest percentage of participants whose appetite was not good experienced osteoporosis (72.7%). The majority of participants (48.4%) with chronic endocrinological diseases had osteoporosis, while the majority of those without chronic endocrinological diseases (56.7%) had osteopenia. A statistically significant weak negative correlation was found between BMD and participants' age (Spearman's rho = -0.129, P value = 0.042). This suggests that as age increases, there is a tendency for BMD to decrease. Also, a statistically significant weak positive correlation was found between BMD and the age of menopause of the female participants (Spearman's rho = 0.197, P value = 0.005). Accordingly, the finding of a positive association suggests that as women's age at menopause increases, so does BMD. Lastly, participants' self-reported age and the SAST score were positively correlated (Spearman's rho = 0.243, P-value < 0.001), suggesting that the higher the SAST score , the greater the participants' feeling of age.
Conclusions: The present study managed to add useful information about the characteristics of the population with low BMD, the association of BMD levels with anxiety and loneliness, as well as with other determinants of health, such as diet, physical activity and others.
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