Cognitive decline is associated with an accelerated rate of bone loss and increased fracture risk in women: a prospective study from the Canadian Multicentre Osteoporosis Study Journal Articles uri icon

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abstract

  • ABSTRACT Cognitive decline and osteoporosis often coexist and some evidence suggests a causal link. However, there are no data on the longitudinal relationship between cognitive decline, bone loss and fracture risk, independent of aging. This study aimed to determine the association between: (i) cognitive decline and bone loss; and (ii) clinically significant cognitive decline (≥3 points) on Mini Mental State Examination (MMSE) over the first 5 years and subsequent fracture risk over the following 10 years. A total of 1741 women and 620 men aged ≥65 years from the population-based Canadian Multicentre Osteoporosis Study were followed from 1997 to 2013. Association between cognitive decline and (i) bone loss was estimated using mixed-effects models; and (ii) fracture risk was estimated using adjusted Cox models. Over 95% of participants had normal cognition at baseline (MMSE ≥ 24). The annual % change in MMSE was similar for both genders (women −0.33, interquartile range [IQR] −0.70 to +0.00; and men −0.34, IQR: −0.99 to 0.01). After multivariable adjustment, cognitive decline was associated with bone loss in women (6.5%; 95% confidence interval [CI], 3.2% to 9.9% for each percent decline in MMSE from baseline) but not men. Approximately 13% of participants experienced significant cognitive decline by year 5. In women, fracture risk was increased significantly (multivariable hazard ratio [HR], 1.61; 95% CI, 1.11 to 2.34). There were too few men to analyze. There was a significant association between cognitive decline and both bone loss and fracture risk, independent of aging, in women. Further studies are needed to determine mechanisms that link these common conditions. © 2021 American Society for Bone and Mineral Research (ASBMR).

authors

  • Bliuc, Dana
  • Tran, Thach
  • Adachi, Jonathan Derrick
  • Atkins, Gerald J
  • Berger, Claudie
  • van den Bergh, Joop
  • Cappai, Roberto
  • Eisman, John A
  • van Geel, Tineke
  • Geusens, Piet
  • Goltzman, David
  • Hanley, David A
  • Josse, Robert
  • Kaiser, Stephanie
  • Kovacs, Christopher S
  • Langsetmo, Lisa
  • Prior, Jerilynn C
  • Nguyen, Tuan V
  • Solomon, Lucian B
  • Stapledon, Catherine
  • Center, Jacqueline R

publication date

  • November 1, 2021