Abstract: Objective To analyze the incidence of osteoporosis in schizophrenia patients and explore its influencing factors, providing a reference for developing preventive strategies. Methods Schizophrenia patients aged 60 or older admitted to the Seventh People's Hospital of Hengshui from January 2021 to October 2024 were surveyed. Bone mineral density (BMD) was measured using a dual-energy X-ray absorptiometry (DXA), and additional questionnaires were administered. Descriptive analysis was used to evaluate the incidence of osteoporosis, and univariate and multivariate logistic regression analyses were performed to identify influencing factors. Results Among 2 725 schizophrenia patients aged 60 or older, 298 cases of osteoporosis were identified, with an incidence rate of 10.94%. Multivariate logistic regression analysis revealed that age 75-85 years (OR=2.452), underweight (OR=4.125), male gender (OR=2.787), hyperprolactinemia (OR=2.404), 25-hydroxyvitamin D [25(OH)D] deficiency (OR=2.855), hypocalcemia (OR=2.542), combined antipsychotic medication use (OR=3.056), and antipsychotic medication use for ≥10 years (OR=2.596) were independent risk factors for osteoporosis (all P<0.05). Conclusions Elderly patients with schizophrenia face a certain risk of osteoporosis, influenced by factors such as age, underweight, gender, hyperprolactinemia, 25(OH)D deficiency, hypocalcemia, antipsychotic medication use, and duration of use. Early identification and management of these risk factors can effectively reduce the risk of osteoporosis.

Key words: Schizophrenia, Osteoporosis, Hyperprolactinemia, Vitamin D deficiency, Hypocalcemia, Antipsychotic medications