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. (20th July 2021)

• Record Type: Journal Article
• Authors: Bliuc, Dana; Tran, Thach; Adachi, Jonathan D.; 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.
• Is Part Of: Journal of bone and mineral research. Volume 36:Number 11(2021)
• Page Start: 2106
• Page End: 2115
• Publication Date: 2021-07-20
• Subjects: AGING -- BONE MINERAL DENSITY -- COGNITIVE PERFORMANCE -- LONGITUDINAL STUDY -- OSTEOPOROSIS; Bones -- Metabolism -- Periodicals; Mineral metabolism -- Periodicals; 612.392
• DOI: 10.1002/jbmr.4402
• Languages: English
• ISSNs: 0884-0431

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).