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
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
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DOI：
10.1002/jbmr.4402
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发表时间：
2021-07-20
影响因子：
6.2
通讯作者：
Center, Jacqueline R.
中科院分区：
文献类型：
--
作者：
Bliuc, Dana;Tran, Thach;Center, Jacqueline R.
认知能力下降和骨质疏松症常常同时存在，一些证据表明两者之间存在因果关系。然而，没有关于认知能力下降、骨质流失和骨折风险之间独立于衰老的纵向关系的数据。本研究旨在确定：(i) 认知能力下降和骨质流失之间的关联； (ii) 前 5 年内简易精神状态检查 (MMSE) 出现临床显着认知能力下降（>= 3 分），以及接下来 10 年内的骨折风险。 1997 年至 2013 年，加拿大多中心骨质疏松症研究对 1741 名年龄≥ 65 岁的女性和 620 名男性进行了跟踪调查。 (ii) 使用调整后的 Cox 模型估计骨折风险。超过 95% 的参与者在基线时认知能力正常 (MMSE >= 24)。两种性别的 MMSE 年度变化百分比相似（女性 -0.33，四分位距 [IQR] -0.70 至 +0.00；男性 -0.34，IQR：-0.99 至 0.01）。经过多变量调整后，女性的认知能力下降与骨质流失相关（6.5%；95%置信区间[CI]，MMSE相对于基线每下降一个百分点，认知能力下降与骨质流失相关3.2%至9.9%），但与男性无关。大约 13% 的参与者在第 5 年出现认知能力显着下降。女性骨折风险显着增加（多变量风险比 [HR]，1.61；95% CI，1.11 至 2.34）。人太少，无法分析。女性认知能力下降与骨质流失和骨折风险之间存在显着关联，与年龄无关。需要进一步的研究来确定这些常见病症之间的联系机制。 (c) 2021 年美国骨与矿物质研究学会 (ASBMR)。
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. (c) 2021 American Society for Bone and Mineral Research (ASBMR).