In the JournalsPerspective

Osteoporosis linked to higher risk for dementia

Karel Kostev

Osteoporosis is associated with a 1.3-fold increase in the risk for dementia among men, and a 1.2-fold increase among women, according to findings published in the Journal of Alzheimer’s Disease.

“There is big interest in the relationship between osteoporosis and dementia — both conditions have a high prevalence, especially in elderly population,” Karel Kostev, DrMS, of IQVIA, Frankfurt, Germany, told Healio Rheumatology. “Anti-dementia medication is usually helpful when it is given in the early stage of disease, so it is important to find factors increasing the risk of dementia to prevent it as soon as possible.”

To evaluate how osteoporosis affects the risk for dementia over the course of 2 decades, Kostev and colleagues conducted a retrospective cohort study using IQVIA’s Disease Analyzer database, which compiles anonymous information on drug prescriptions, diagnoses and basic medical and demographic data obtained directly from computer systems from general practitioners in Germany. For their study, the researchers focused on 29,983 patients with osteoporosis who were followed by 1,215 German general practitioners between January 1993 and December 2012.

Osteoporosis is associated with a 1.3-fold increase in the risk for dementia among men, and a 1.2-fold increase among women, according to findings.
Source: Shutterstock

The study also included 29,983 control participants who were matched to patients with osteoporosis based on age, gender, index year, comorbidities and co-therapies. The main outcome of the study was the proportion of participants with diagnoses of dementia within 20 years of the index date. Kostev and colleagues used Kaplan-Meier curves to study the development of dementia separately in men and women, as well as Cox proportional regression models to estimate the relationship between osteoporosis and dementia.

According to the researchers, 20.5% of women with osteoporosis, as well as 16.4% of women in the control group, were diagnosed with dementia within 20 years of the index date (P < .001). Among men, 22% of patients with osteoporosis, and 14.9% of those in the control group, were diagnosed with dementia (P < .001).

“The major hypothesis to explain the association between osteoporosis and dementia is that these two conditions have similar risk factors,” Kostev said. “Physicians who diagnose and treat osteoporosis — including orthopedists and, partly, gynecologists — should recommend their patients receive memory checks or refer then to neurologists at least once per year. Neurologists should check patients for dementia or even mild cognitive impairment when they know that these patients have osteoporosis.” – by Jason Laday

Disclosure: Kostev reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Karel Kostev

Osteoporosis is associated with a 1.3-fold increase in the risk for dementia among men, and a 1.2-fold increase among women, according to findings published in the Journal of Alzheimer’s Disease.

“There is big interest in the relationship between osteoporosis and dementia — both conditions have a high prevalence, especially in elderly population,” Karel Kostev, DrMS, of IQVIA, Frankfurt, Germany, told Healio Rheumatology. “Anti-dementia medication is usually helpful when it is given in the early stage of disease, so it is important to find factors increasing the risk of dementia to prevent it as soon as possible.”

To evaluate how osteoporosis affects the risk for dementia over the course of 2 decades, Kostev and colleagues conducted a retrospective cohort study using IQVIA’s Disease Analyzer database, which compiles anonymous information on drug prescriptions, diagnoses and basic medical and demographic data obtained directly from computer systems from general practitioners in Germany. For their study, the researchers focused on 29,983 patients with osteoporosis who were followed by 1,215 German general practitioners between January 1993 and December 2012.

Osteoporosis is associated with a 1.3-fold increase in the risk for dementia among men, and a 1.2-fold increase among women, according to findings.
Source: Shutterstock

The study also included 29,983 control participants who were matched to patients with osteoporosis based on age, gender, index year, comorbidities and co-therapies. The main outcome of the study was the proportion of participants with diagnoses of dementia within 20 years of the index date. Kostev and colleagues used Kaplan-Meier curves to study the development of dementia separately in men and women, as well as Cox proportional regression models to estimate the relationship between osteoporosis and dementia.

According to the researchers, 20.5% of women with osteoporosis, as well as 16.4% of women in the control group, were diagnosed with dementia within 20 years of the index date (P < .001). Among men, 22% of patients with osteoporosis, and 14.9% of those in the control group, were diagnosed with dementia (P < .001).

“The major hypothesis to explain the association between osteoporosis and dementia is that these two conditions have similar risk factors,” Kostev said. “Physicians who diagnose and treat osteoporosis — including orthopedists and, partly, gynecologists — should recommend their patients receive memory checks or refer then to neurologists at least once per year. Neurologists should check patients for dementia or even mild cognitive impairment when they know that these patients have osteoporosis.” – by Jason Laday

Disclosure: Kostev reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

    Perspective
    Eileen J. Lydon

    Eileen J. Lydon

    In a large cohort of patients in general practices in Germany followed over a period of 20 years, Kostev and colleagues found a positive association between osteoporosis and dementia. The researchers determined that patients with a diagnosis of osteoporosis at baseline were at increased risk for developing dementia.

    Although previous studies have also found a similar association, this study followed a large number of participants over an extended period of time. Limitations included a lack of information regarding bone mineral density and lifestyle-related factors.

    Dementia and osteoporosis have similar risk factors, which is the likely explanation of this finding. However, these findings should alert health care providers caring for an osteoporotic patient to assess for signs and symptoms of dementia, and refer for screening if suspected. Early identification of dementia may improve outcomes overall. These findings should be studied further in order to optimize the care of this population. 

    • Eileen J. Lydon, MA, RN, ANP-BC
    • Board member, Rheumatology Nurses Society
      Nurse practitioner
      New York University Hospital for Joint Diseases

    Disclosures: Lydon reports no relevant financial disclosures.