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Dementia Risk Higher in People With Low Femoral Neck, Total Body BMD

Jolynn Tumolo

Low femoral neck and total body bone mineral density (BMD), as well as low trabecular bone score, were associated with an increased risk of dementia in study findings published in Neurology.

“Indeed, we do not feel that BMD per se is causally related to dementia. Unraveling such etiologic link could, for instance, be a topic of study in Mendelian Randomization studies,” wrote corresponding author M. Arfan Ikram, MD, PhD, and coauthors from the Erasmus MC University Medical Center Rotterdam in the Netherlands. “Nevertheless, as an indicator of dementia risk, intervening in BMD may improve clinical care of these persons, especially considering the multi-comorbidities … that are highly preventive in this group.”

The population-based cohort study included 3651 participants without dementia at baseline. Femoral neck BMD, lumbar spine BMD, total body BMD, and trabecular bone score were obtained using dual-energy X-ray absorptiometry between 2002 and 2005. Participants were followed through 2019.

Over a median 11.1 years, 18.8% of participants developed incident dementia. Among them, 76.7% developed Alzheimer disease, according to the study.

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Participants with lower BMD at the femoral neck, but not at other bone sites, were more likely to develop all-cause dementia. Hazard ratios with low femoral neck BMD, per standard deviation decrease, were 1.12 for dementia and 1.14 for Alzheimer disease across the entire follow-up period, the study showed.

Associations were strongest during the first 10 years of follow-up. Specifically, hazard ratios for dementia were 2.03 for those in the lowest tertile for femoral neck BMD, 1.42 for those in the lowest tertile for total body BMD, and 1.59 for those in the lowest tertile for trabecular bone score.

“In conclusion, participants with low femoral neck and total body BMD and low trabecular bone score were more likely to develop dementia,” researchers wrote. “Further studies should focus on the predictive ability of BMD for dementia.”

 

Reference

Xiao T, Ghatan S, Mooldijk SS, ET AL. Association of bone mineral density and dementia: The Rotterdam Study. Neurology. Published online March 22, 2023. doi:10.1212/WNL.0000000000207220

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