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

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 À0.33, interquartile range [IQR] À0.70 to +0.00; and men À0.34, IQR: À0.99 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

Metabolic Alterations in Cellular Senescence: The Role of Citrate in Ageing and Age-Related Disease

“…Drugs targeting SLC13A5/INDY are now available and are reported to work in vitro [ 101 ] and in vivo [ 104 ]. Furthermore, bone is the main site of citrate storage in mammals, and bone demineralization is likely to release citrate in individuals with osteoporosis, which has recently been linked with dementia in humans [ 105 , 106 ].…”

Musculoskeletal Deficits and Cognitive Impairment: Epidemiological Evidence and Biological Mechanisms

“…Using the Canadian Multicentre Osteoporosis Study (CaMos), the relationship between cognitive decline, bone loss, and fracture risk was examined in 2361 participants (74% female) selected from the general population [60]. Cognition was assessed using the MMSE.…”

“…Musculoskeletal and cognitive function declines often occur at the same time, for example with aging or in individuals with dementia [1][2][3]. Cognition is an intellectual or mental process via which organisms obtain knowledge and cognitive impairment (diminished intellectual and/or mental functioning) is associated with obesity [4].…”

Letter to the Editor Regarding “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”

“…In a recent issue of the Journal of Bone and Mineral Research (JBMR), Bliuc and colleagues (1) reported an association of cognitive decline with bone loss and an increased risk of fracture in nondemented older women. They found that a decline in cognitive performance by 1% resulted in a decline in bone loss by 6% in long-term follow-up, providing possible evidence for the association between dementia and osteoporosis.…”