Bone Mineral Density Measurements and Association With Brain Structure and Cognitive Function

Stefanidou, Maria; O’Donnell, Adrienne; Himali, Jayandra J.; DeCarli, Charles; Beiser, Alexa S.; Seshadri, Sudha; Zaldy, Tan

doi:10.1097/wad.0000000000000453

Cited by 12 publications

(9 citation statements)

References 52 publications

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“…Data from the Framingham Offspring Cohort Study in the USA were used to examine the association between BMD and brain structure, and BMD and cognitive function [109]. This study included 1905 men and women (mean age =66 years).…”

Section: Musculoskeletal Health and Alzheimer's Disease The Potential...mentioning

confidence: 99%

“…This study reported sex-specific associations between higher BMD and better cognitive performance and less white matter hyperintensity burden. The authors proposed cumulative estrogen exposure as the potential underlying mechanism [109]. A large-scale study using a neurobiological approach combining neuroimaging techniques with the biological mechanism is expected to be conducted in this area [44].…”

Section: Musculoskeletal Health and Alzheimer's Disease The Potential...mentioning

confidence: 99%

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Musculoskeletal Deficits and Cognitive Impairment: Epidemiological Evidence and Biological Mechanisms

Sui

Balanta‐Melo

Pasco

et al. 2022

Curr Osteoporos Rep

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Purpose of Review Cognitive impairment is associated with obesity, sarcopenia, and osteoporosis. However, no critical appraisal of the literature on the relationship between musculoskeletal deficits and cognitive impairment, focusing on the epidemiological evidence and biological mechanisms, has been published to date. Herein, we critically evaluate the literature published over the past 3 years, emphasizing interesting and important new findings, and provide an outline of future directions that will improve our understanding of the connections between the brain and the musculoskeletal system. Recent Findings Recent literature suggests that musculoskeletal deficits and cognitive impairment share pathophysiological pathways and risk factors. Cytokines and hormones affect both the brain and the musculoskeletal system; yet, lack of unified definitions and standards makes it difficult to compare studies. Summary Interventions designed to improve musculoskeletal health are plausible means of preventing or slowing cognitive impairment. We highlight several musculoskeletal health interventions that show potential in this regard.

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Section: Musculoskeletal Health and Alzheimer's Disease The Potential...mentioning

confidence: 99%

Section: Musculoskeletal Health and Alzheimer's Disease The Potential...mentioning

confidence: 99%

Musculoskeletal Deficits and Cognitive Impairment: Epidemiological Evidence and Biological Mechanisms

Sui

Balanta‐Melo

Pasco

et al. 2022

Curr Osteoporos Rep

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“…The association between bone mineral density (BMD) and dementia has been found in many studies. [1][2][3][4][5][6][7] It may be due to common risk factors that include age, lifestyle factors including lack of physical activity and smoking, vitamin D deficiency, and ApoE4 genotype, 8 and common mechanisms such as estrogen signaling, inflammation, brain-derived molecules affecting bone, and bone-derived mediators affecting the brain. 9 Low BMD has been associated with time to Alzheimer's disease (AD) in a Chinese cohort study, 1 and with both time to AD and all-cause dementia in the Framingham Heart Study (FHS) in women, but not men.…”

Section: Introductionmentioning

confidence: 99%

“…2 Low BMD was also associated with brain structural changes and cognitive performance in FHS. 3 Two large US-based prospective studies found women with more rapid bone loss were more likely to develop cognitive decline. 4,5 More recently, a large Canadian-based cohort study found a significant association between cognitive decline and bone loss that was strongest in women, 6 and a large prospective study from Hong Kong showed low BMD at multiple skeletal sites to be associated with incident dementia.…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density and the risk of incident dementia: A meta‐analysis

Lary,

Ghatan,

Gerety

et al. 2023

J American Geriatrics Society

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BackgroundIt is not known whether bone mineral density (BMD) measured at baseline or as the rate of decline prior to baseline (prior bone loss) is a stronger predictor of incident dementia or Alzheimer's disease (AD).MethodsWe performed a meta‐analysis of three longitudinal studies, the Framingham Heart Study (FHS), the Rotterdam Study (RS), and the Rush Memory and Aging Project (MAP), modeling the time to diagnosis of dementia as a function of BMD measures accounting for covariates. We included individuals with one or two BMD assessments, aged ≥60 years, and free of dementia at baseline with follow‐up available. BMD was measured at the hip femoral neck using dual‐energy X‐ray absorptiometry (DXA), or at the heel calcaneus using quantitative ultrasound to calculate estimated BMD (eBMD). BMD at study baseline (“baseline BMD”) and annualized percentage change in BMD prior to baseline (“prior bone loss”) were included as continuous measures. The primary outcome was incident dementia diagnosis within 10 years of baseline, and incident AD was a secondary outcome. Baseline covariates included age, sex, body mass index, ApoE4 genotype, and education.ResultsThe combined sample size across all three studies was 4431 with 606 incident dementia diagnoses, 498 of which were AD. A meta‐analysis of baseline BMD across three studies showed higher BMD to have a significant protective association with incident dementia with a hazard ratio of 0.47 (95% CI: 0.23–0.96; p = 0.038) per increase in g/cm2, or 0.91 (95% CI: 0.84–0.995) per standard deviation increase. We observed a significant association between prior bone loss and incident dementia with a hazard ratio of 1.30 (95% CI: 1.12–1.51; p < 0.001) per percent increase in prior bone loss only in the FHS cohort.ConclusionsBaseline BMD but not prior bone loss was associated with incident dementia in a meta‐analysis across three studies.

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“…(9,10) Indeed, studies often consider BMD as a measure of lifetime exposure to estrogen in measuring its impact on dementia and brain function. (11,12) In addition to estrogen, immunological factors may contribute to both bone loss (13) and dementia. (14) In addition, bone-derived proteins and cells may influence AD progression, (15) with AD progression associated with serum levels of the bone turnover markers osteopontin, osteocalcin, and sclerostin, (15) and AD patients and patients with mild cognitive impairment (MCI) reporting higher levels of osteopontin (16) that correlate with reduced BMD and cognitive decline.…”

mentioning

confidence: 99%