Impact of osteoporosis on the risk of dementia in almost 60,000 patients

August 20, 2018, IOS Press

Osteoporosis is estimated to affect 200 million women across the world. In Germany, the prevalence of this chronic disease among people aged 50 years and older is around 15%. In recent decades, several authors have analyzed the impact of osteoporosis on the risk of cognitive decline, but, most of these studies have been conducted outside Europe. The goal of the present study was to investigate the impact of osteoporosis on the risk of developing dementia in almost 60,000 patients followed for up to 20 years in more than 1,200 general practices in Germany.

"There is big interest in the relationship between osteoporosis and dementia," explained lead investigator Prof. Karel Kostev, Dr. MS, from the Epidemiology Team of IQVIA, Frankfurt, Germany. "This study is the first to address this question in a very large database enabling the case-control-comparison between with and without osteoporosis."

This used data from the Disease Analyzer database (IQVIA), which compiles information on , diagnoses, and demographic data obtained directly and in anonymous format from computer systems used by general practitioners and specialists. This database has already been used in several studies focusing on osteoporosis and dementia in recent years. The study included patients diagnosed with osteoporosis between January 1993 and December 2012 (index date) and were followed for up to 20 years. After applying similar inclusion criteria, controls were matched (1:1) to osteoporosis patients using propensity scores based on age, gender, index year, several comorbidities, and co-therapies. The main outcome of the study was to determine the proportion of patients with all-cause-dementia diagnoses within 20 years of the index date.

The present study included 29,983 patients with osteoporosis and 29,983 controls without osteoporosis. After 20 years of follow-up, 20.5% of women with osteoporosis and 16.4% of controls had been diagnosed with dementia (p-value<0.001). At the end of the follow-up period, dementia was found in 22.0% of men previously diagnosed with osteoporosis and 14.9% of men without this chronic condition (p-value<0.001). Osteoporosis was associated with a 1.2-fold increase in the risk of being diagnosed with dementia in women and a 1.3-fold increase in the risk of being diagnosed with dementia in men.

"The major hypothesis to explain the association between and is that these two conditions have similar risk factors noted co-author Louis Jacob, MD, from the university clinic of Paris 5, "These factors include APOE4 allele of the apolipoprotein E, a major cholesterol carrier, lower vitamin K levels, vitamin D deficiency, but also androgens and estrogens.".

The main limitations of the study are missing data on bone mineral density and on lifestyle-related risk factors (e.g., smoking, alcohol, and physical activity). The strengths of this work are the number of patients available for analysis, the duration of follow-up, and the use of real-world data pertaining to diagnoses in primary care practices where diagnoses are continuously documented, allowing for unbiased exposure assessment (no recall bias).

Explore further: Drop in osteoporosis treatment initiation after hip fracture

More information: Karel Kostev et al, Impact of Osteoporosis on the Risk of Dementia in Almost 60,000 Patients Followed in General Practices in Germany, Journal of Alzheimer's Disease (2018). DOI: 10.3233/JAD-180569

Related Stories

Drop in osteoporosis treatment initiation after hip fracture

July 27, 2018
(HealthDay)—In recent years there have been low rates of osteoporosis treatment initiation after a hip fracture, according to research published in the July 20 issue of JAMA Network Open.

What's the life expectancy of patients when they begin treatment for osteoporosis?

April 20, 2015
Despite reports that people with osteoporosis have an increased risk of dying prematurely, a new study has found that life expectancy of newly diagnosed and treated osteoporosis patients is in excess of 15 years in women ...

Osteoporosis drug may benefit heart health

May 11, 2018
The osteoporosis drug alendronate was linked with a reduced risk of cardiovascular death, heart attack, and stroke in a Journal of Bone and Mineral Research study of patients with hip fractures. The association was seen for ...

USPSTF favors osteoporosis screening to prevent fracture

June 28, 2018
(HealthDay)—The U.S. Preventive Services Task Force (USPSTF) recommends screening for osteoporosis to prevent fractures for women aged ≥65 years and for postmenopausal women aged

Older women show limited understanding of osteoporosis

April 28, 2017
(HealthDay)—Many older women have low awareness about osteoporosis and its contribution to fracture risk and a lack of understanding about the benefits of osteoporosis pharmacotherapy, according to a study published April ...

Osteoporosis screening and treatment fall short for women with hip fractures

February 23, 2017
It's important to identify and treat osteoporosis following hip fracture, but a large study found low rates of assessment and treatment in postmenopausal women who had suffered a hip fracture.

Recommended for you

Meditation and music may alter blood markers of cellular aging and Alzheimer's disease

November 13, 2018
A research team led by Dr. Kim Innes, a professor in the West Virginia University School of Public Health, has found that a simple meditation or music listening program may alter certain biomarkers of cellular aging and Alzheimer's ...

Alzheimer's and cardiovascular disease share common genetics in some patients

November 9, 2018
Genetics may predispose some people to both Alzheimer's disease and high levels of blood lipids such as cholesterol, a common feature of cardiovascular disease, according to a new study by an international team of researchers ...

Artificial intelligence predicts Alzheimer's years before diagnosis

November 6, 2018
Artificial intelligence (AI) technology improves the ability of brain imaging to predict Alzheimer's disease, according to a study published in the journal Radiology.

Diabetes medications may reduce Alzheimer's disease severity

November 1, 2018
People with Alzheimer's disease who were treated with diabetes drugs showed considerably fewer markers of the disease—including abnormal microvasculature and disregulated gene expressions—in their brains compared to Alzheimer's ...

Massive study confirms that loneliness increases risk of dementia

October 29, 2018
A new Florida State University College of Medicine study involving data from 12,000 participants collected over 10 years confirms the heavy toll that loneliness can take on your health: It increases your risk of dementia ...

Bioactive compound from the Rhodiola plant improves memory

October 25, 2018
In an ageing society, more people are suffering from memory disorders. The progressive loss of memory severely impairs the quality of life of those affected. So far, no drugs are known to prevent age-related cognitive decline.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.