At surface level, few people might link bone health and brain health. But a new study conducted by researchers from the Epidemiology Team of IQVIA, a healthcare data science company based in Frankfurt, Germany- set out to explore the relationship, with surprising results. The data was published in the Journal of Alzheimer’s Disease, March 2023.
The researchers used data from the Disease Analyzer database, which compiles information about diagnoses, prescriptions, and demographic information taken from computer systems used by doctors. Over 60,000 participants were included in the study, with roughly half having osteoporosis.
The study lasted over a period of 20 years, taking into account other factors that might impact results such as other medical conditions, medications, age, and gender.
The data revealed that women that had osteoporosis had a 30% higher risk of dementia compared to those without osteoporosis. For men, the risk increased by 20% compared to counterparts without osteoporosis.
What is the link between Osteoporosis and Dementia?
While there is no definitive answer to this question, co-author Dr. Louis Jacob explains, “The major hypothesis to explain the association between osteoporosis and dementia is that these two conditions have similar risk factors.” There are biomarkers that are found in both conditions. For example, “ApoE4 increases the risk of both dementia and osteoporosis. Similarly, lower levels of vitamin K, vitamin D, androgens (such as testosterone), and estrogens also raise the risk of both conditions.”
The researchers state that while it may be a case of parallel risk factors, “The research is compelling due to the length and the number of study subjects involved and the evidence is strong enough to surmise that there may, in fact, be a link between the condition and the disease.”
Osteoporosis risk factors
If that hypothesis does stand and the link between osteoporosis and dementia is a result of similar risk factors, addressing those factors may protect against both diseases.
Osteoporosis is a bone disease which results in the bones becoming porous and weak. We can identify those with high risk of osteoporosis by using “s.c.o.r.e.”–a simple calculated osteoporosis risk estimation. That is defined by age, weight, race, estrogen use, previous fractures, and rheumatoid arthritis. The rate of bone loss varies from person to person. But around midlife, bones become thinner. How fast or how slow you lose bone depends on a number of factors:
• Your activity level- increased activity levels and exercise decrease risk
• Your family history- if your family has osteoporosis, you’re at higher risk
• Certain medications
• Race- White and Asian women have the greatest risk.
• Age- The chances are higher for women over 50 and go up with age.
• Weight- Thin women are at higher risk.
• Smokers- People who smoke lose bone thickness faster than nonsmokers
• Lifestyle habits-alcohol consumption increases risk
• Rheumatoid Arthritis- Studies have found an increased risk of bone loss and fracture in individuals with rheumatoid arthritis. The glucocorticoid medications often prescribed for the treatment of rheumatoid arthritis can trigger significant bone loss. In addition, pain and loss of joint function caused by the disease can result in inactivity, further increasing osteoporosis risk.
• Early menopause- Women who went through it before age 50 have higher chances of getting osteoporosis. Estrogen is important for maintaining bone density in women. When estrogen levels drop after menopause, bone loss speeds up. This can happen with natural menopause or an early surgical menopause if you have your ovaries removed. During the first 5 to 10 years after menopause, women can lose about 2.5% of bone density each year. That means they can lose as much as 25% of their bone density during that time. Accelerated bone loss after menopause is a major cause of osteoporosis in women. For women, having the strongest bones possible before you enter menopause is the best protection against debilitating fractures.
• Men also get osteoporosis. In fact, about 2 million men over age 65 have osteoporosis. Osteoporosis usually starts later and progresses more slowly in men. Still, osteoporosis in men can be just as disabling and painful as it is in women. According to the article in JAMA, one in five men, 50 years and older will experience an osteopathic fracture in his lifetime. Mortality after hip fractures is higher among men than women.
Dementia risk factors
Dementia is an umbrella term that encompasses symptoms that include changes to memory, thinking, and social abilities. Sources share that the main cause of dementia is damage to brain cells or loss of nerve cells and their connection to the brain. This might occur as a result of (this list is not exhaustive):
- Advance age, as in case of Alzheimer’s disease
- Family history
- Damage to blood vessels of the brain
- Accumulation of clumps of protein in the brain
- Genetic disorders such as Huntington’s disease
- Mental and neurological disorders such as Parkinson’s disease and depression
- Traumatic brain injury or repetitive brain injury as seen in boxers
- Infections which cause high fever
- Metabolic disorders such as thyroid problems and diabetes
- Certain medications
- Vitamin deficiencies
- Poisoning with heavy metals or pesticides
- Alcohol abuse
- Brain tumor or cancer
- Enlarged structures of the brain
While further studies need to explore what the exact link is between osteoporosis and dementia, managing the controllable risk factors will ultimately better protect your health.