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

For the Canadian Multicentre Osteoporosis Study (CaMos) Research Group

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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.

Original languageEnglish (US)
JournalJournal of Bone and Mineral Research
Early online dateJul 20 2021
DOIs
StateE-pub ahead of print - Jul 20 2021

Bibliographical note

Funding Information:
The Canadian Multicentre Osteoporosis Study was funded by the Canadian Institutes of Health Research (CIHR); Merck Frosst Canada Ltd.; Eli Lilly Canada Inc.; Novartis Pharmaceuticals Inc.; The Alliance: sanofi‐aventis & Procter and Gamble Pharmaceuticals Canada Inc.; Servier Canada Inc.; Amgen Canada Inc.; The Dairy Farmers of Canada; and The Arthritis Society. This work was supported by the National Health Medical Research Council Australia Projects 1070187, 1008219, and 1073430. Other funding bodies were an Osteoporosis Australia‐Amgen grant; the Bupa Health Foundation (formerly MBF Foundation); the Mrs Gibson and Ernst Heine Family Foundation; and untied grants from Amgen, Merck Sharp & Dohme, Sanofi‐Aventis, Servier, and Novartis.

Funding Information:
Jonathan D. Adachi has received research grants and/or personal fees from Amgen, Eli Lilly, Merck, Actavis, and AgNovos. Joop van den Bergh has received grants and/or personal fees from Amgen, MSD, and Eli Lilly. John A. Eisman has consulted for and/or received research funding from Amgen, deCode, Merck Sharp and Dohme, and Sanofi‐Aventis. Piet Geusens was an advisory member for Amgen, and has received speaker fee and/or research grants from Amgen, Pfizer, MSD, UCB, Abbott, Lilly, BMS, Novartis, Roche and Will Pharma. David A. Hanley has consulted for and/or received speaker fee and/or research funding from Amgen, Merck, and Eli Lilly. Tuan V. Nguyen has received honoraria for consulting and symposia from Merck Sharp and Dohme, Roche, Servier, Sanofi‐Aventis, and Novartis. Jerilynn C. Prior has consulted for and/or given educational talks for Merck Sharp and Dohme, Amgen, Actavis, Bayer, and Sanofi‐Aventis. Jacqueline R Center has consulted for and/or given educational talks for Amgen, Actavis and Bayer. Dana Bliuc, Thach Tran, Tineke van Geel, Claudie Berger, David Goltzman, Robert Josse, Lisa Langsetmo, Gerald J. Atkins, Lucian B. Solomon, Roberto Cappai, Catherine Stapledon, Christopher S. Kovacs, and Stephanie Kaiser have no competing interests to declare.

Publisher Copyright:
© 2021 American Society for Bone and Mineral Research (ASBMR).

Keywords

  • AGING
  • BONE MINERAL DENSITY
  • COGNITIVE PERFORMANCE
  • LONGITUDINAL STUDY
  • OSTEOPOROSIS

PubMed: MeSH publication types

  • Journal Article

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