Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 36(11), 2106-2115, 2021
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
Bliuc D, Tran T, Adachi JD, Atkins GJ, Berger C, van den Bergh J, Cappai R, Eisman JA, van Geel T, Geusens P, Goltzman D, Hanley DA, Josse R, Kaiser S, Kovacs CS, Langsetmo L, Prior JC, Nguyen TV, Solomon LB, Stapledon C, Center JR
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.
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PMID 34289172 34289172 DOI 10.1002/jbmr.4402 10.1002/jbmr.4402
Cite this article
Bliuc, D., Tran, T., Adachi, J. D., Atkins, G. J., Berger, C., van den Bergh, J., Cappai, R., Eisman, J. A., van Geel, T., Geusens, P., Goltzman, D., Hanley, D. A., Josse, R., Kaiser, S., Kovacs, C. S., Langsetmo, L., Prior, J. C., Nguyen, T. V., Solomon, L. B., . . . Canadian Multicentre Osteoporosis Study (CaMos) Research Group (2021). 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 of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 36(11), 2106-2115. https://doi.org/10.1002/jbmr.4402
Bliuc D, Tran T, Adachi JD, Atkins GJ, Berger C, van den Bergh J, et al. 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. J Bone Miner Res. 2021;36(11):2106-2115. doi:10.1002/jbmr.4402
Bliuc, D., et al. "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 of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, vol. 36, no. 11, 2021, pp. 2106-2115.
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