Being elderly and depressed and lonely significantly increases the chances that you will break bones if you fall over, suggests a large study.

Researchers found that the 10 per cent of women over 50 with the highest levels of mental distress had double the risk of fracturing a hip than the 10 per cent with the lowest levels.

And a connection to unsteadiness caused by medication for depression or anxiety has been ruled out by the research team from the National Institute of Public Health in Oslo, Norway.

The most likely explanations reached by the scientists were that mental distress might increase the risk of fractures because people in this situation tended not to look after their diet.

Poor diet harms bones

Poor diet is a well-known contributory factor to osteoporosis, or brittle bone disease, in later life.

But it is possible, as other studies have suggested, that increased levels of the hormone produced by stress, cortisol, could adversely affect bone tissue.

The extensive study, published in the Journal of Epidemiology and Community Health, involved more than 18,000 women.

Old people are left heavily disabled after damaging falls

Over three years, 329 of them suffered a hip fracture, and they were all asked questions relating to loneliness, life satisfaction, sleep disorders, anxiety and general mood.

Traditional factors known to increase the risk that falling will break a hip, such as body weight, smoking, inactivity and other illness were taken into account.

Dr Janet Simpson, a physiotherapist and psychologist at St George's hospital in London, who has a special interest in falls by the elderly, agreed that depressed people tended not to look after their diet as well.

She said: "Elderly people are falling down like ninepins, but injury rates are quite low, in terms of actually getting serious injury like a broken hip.

"I think it is possible that depressed people are not looking after their diet as well, and this is contributing to osteoporosis."

A spokeswoman for Age Concern said that injuries from falls in the home were a major issue.

She said: "The risk increases substantially the older you get - you are five times more likely to fall if you are 85 than if you are 65."

Age Concern have published advice to the elderly to help prevent slips and falls which could cause injury.

Points include taking regular exercise to keep muscles strong and joints supple, keeping living areas well lit, fitting grab rails on stairways and near the bath/toilet, and having regular eye tests.