Low Bone Mineral Density With Risk of Dementia: A Prospective Cohort Study

Zhang, Xiaowen; Hsu, Warrington W.Q.; Sing, Chor‐Wing; Li, Gloria Hoi-Yee; Tan, K. C. B.; Kung, A. W. C.; Wong, Janus Siu-Him; Wong, Ian C. K.; Cheung, Ching‐Lung

doi:10.1016/j.jamda.2022.07.012

Cited by 7 publications

(9 citation statements)

References 28 publications

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“…Our study is the first to measure the association between prior bone loss and incident dementia and to compare the association between baseline BMD and prior bone loss with incident dementia in the same study. Our positive results for baseline BMD and dementia are consistent with prior studies, 1,2,7 and while our results for bone loss and dementia do not have precedent, other studies have shown a significant association between bone loss and cognitive decline 4,5 …”

Section: Discussionsupporting

confidence: 92%

“…7 Thus, the associations between baseline BMD and incident dementia, and prior bone loss and cognitive decline, are established. 1,2,4,5,7 However, the association between prior bone loss and incident dementia has not yet been studied. Furthermore, baseline BMD and prior bone loss have not been directly compared for association with incident dementia in the same study.…”

Section: Introductionmentioning

confidence: 99%

“…The association between bone mineral density (BMD) and dementia has been found in many studies 1–7 . 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 .…”

Section: Introductionmentioning

confidence: 99%

“…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 7 …”

Section: Introductionmentioning

confidence: 99%

“…Thus, the associations between baseline BMD and incident dementia, and prior bone loss and cognitive decline, are established 1,2,4,5,7 . However, the association between prior bone loss and incident dementia has not yet been studied.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 92%