Increased Risk of Osteoporosis in Patients with Cognitive Impairment: a Systematic Review and Meta-analysis

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2023 Dec 4

PMID 38049723

Authors

Chengxin Xie

Chenglong Wang

Hua Luo

Affiliations

Soon will be listed here.

Abstract

Background: Both osteoporosis and cognitive impairment affect overall health in elderly individuals. This study aimed to investigate the association between cognitive impairment and the risk of osteoporosis.

Methods: PubMed, Web of Science, and the Cochrane Library were searched for studies on the association between osteoporosis and cognitive impairment from their inception until August 2023. The random-effects model was used to calculate the pooled risk ratio (RR) of osteoporosis in patients with cognitive impairment. Subgroup analysis was used to detect the sources of heterogeneity. Sensitivity analysis was used to test the robustness of the pooled results. Funnel plots, Egger's test, and Begg's test were used to test publication bias.

Results: Ten studies involving 9,872 patients were included in this meta-analysis. The pooled results showed that patients with cognitive impairment had an increased risk of osteoporosis (RR = 1.56, 95% confidence interval [CI]: 1.30-1.87, p < 0.001). Subgroup analysis showed that patients with Alzheimer's disease (AD) are at 1.7-fold risk of osteoporosis compared with the control group (RR = 1.70, 95% CI: 1.23-2.37, p = 0.001), and sex, cognitive classification, study region, study design, and study quality might be the sources of heterogeneity. Sensitivity analysis showed robustness of the pooled results. No significant publication bias was found (Begg's test, p = 0.474; Egger's test, p = 0.065).

Conclusion: Current evidence suggests that patients with cognitive impairment are at increased risk of osteoporosis, especially patients with AD.

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References

Cao Q, Tan C, Xu W, Hu H, Cao X, Dong Q . The Prevalence of Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2019; 73(3):1157-1166. DOI: 10.3233/JAD-191092. View

Dimitri P, Rosen C . The Central Nervous System and Bone Metabolism: An Evolving Story. Calcif Tissue Int. 2016; 100(5):476-485. DOI: 10.1007/s00223-016-0179-6. View

Basgoz B, Ince S, Safer U, Naharci M, Tasci I . Low bone density and osteoporosis among older adults with Alzheimer's disease, vascular dementia, and mixed dementia: A Cross-sectional Study With Prospective Enrollment. Turk J Phys Med Rehabil. 2020; 66(2):193-200. PMC: 7401688. DOI: 10.5606/tftrd.2020.3803. View

Yu F, Xia W . The epidemiology of osteoporosis, associated fragility fractures, and management gap in China. Arch Osteoporos. 2019; 14(1):32. DOI: 10.1007/s11657-018-0549-y. View

Kwon M, Kim J, Kim J, Cho S, Nam E, Choi H . The Occurrence of Alzheimer's Disease and Parkinson's Disease in Individuals With Osteoporosis: A Longitudinal Follow-Up Study Using a National Health Screening Database in Korea. Front Aging Neurosci. 2021; 13:786337. PMC: 8692765. DOI: 10.3389/fnagi.2021.786337. View

Scheltens P, De Strooper B, Kivipelto M, Holstege H, Chetelat G, Teunissen C . Alzheimer's disease. Lancet. 2021; 397(10284):1577-1590. PMC: 8354300. DOI: 10.1016/S0140-6736(20)32205-4. View

Ebrahimpur M, Sharifi F, Shadman Z, Payab M, Mehraban S, Shafiee G . Osteoporosis and cognitive impairment interwoven warning signs: community-based study on older adults-Bushehr Elderly Health (BEH) Program. Arch Osteoporos. 2020; 15(1):140. DOI: 10.1007/s11657-020-00817-1. View

Mughal N, Inderjeeth A, Inderjeeth C . Osteoporosis in patients with dementia is associated with high morbidity and mortality: Findings from a single orthogeriatric unit. Aust J Gen Pract. 2019; 48(1-2):53-58. DOI: 10.31128/AJGP-04-18-4544. View

Guo B, Wang C, Zhu Y, Liu Z, Long H, Ruan Z . Causal associations of brain structure with bone mineral density: a large-scale genetic correlation study. Bone Res. 2023; 11(1):37. PMC: 10359275. DOI: 10.1038/s41413-023-00270-z. View

10.

He S, Qiu S, Pan M, Palavicini J, Wang H, Li X . Central nervous system sulfatide deficiency as a causal factor for bladder disorder in Alzheimer's disease. Clin Transl Med. 2023; 13(7):e1332. PMC: 10361545. DOI: 10.1002/ctm2.1332. View

11.

Stang A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010; 25(9):603-5. DOI: 10.1007/s10654-010-9491-z. View

12.

Xiao T, Ghatan S, Mooldijk S, Trajanoska K, Oei L, Gomez M . Association of Bone Mineral Density and Dementia: The Rotterdam Study. Neurology. 2023; 100(20):e2125-e2133. PMC: 10186235. DOI: 10.1212/WNL.0000000000207220. View

13.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

14.

Otto E, Knapstein P, Jahn D, Appelt J, Frosch K, Tsitsilonis S . Crosstalk of Brain and Bone-Clinical Observations and Their Molecular Bases. Int J Mol Sci. 2020; 21(14). PMC: 7404044. DOI: 10.3390/ijms21144946. View

15.

Liu X, Chen C, Jiang Y, Wan M, Jiao B, Liao X . Brain-derived extracellular vesicles promote bone-fat imbalance in Alzheimer's disease. Int J Biol Sci. 2023; 19(8):2409-2427. PMC: 10197897. DOI: 10.7150/ijbs.79461. View

16.

Liu X, Wu P, Liu Y, Jiang Y, Wan M, Xiao X . Association Between Serum Vitamins and the Risk of Alzheimer's Disease in Chinese Population. J Alzheimers Dis. 2021; 85(2):829-836. DOI: 10.3233/JAD-215104. View

17.

Hermanns N, Wroblewski V, Bascunana P, Wolf B, Polyak A, Ross T . Molecular imaging of the brain-heart axis provides insights into cardiac dysfunction after cerebral ischemia. Basic Res Cardiol. 2022; 117(1):52. PMC: 9592646. DOI: 10.1007/s00395-022-00961-4. View

18.

Moskalewicz A, Oremus M . No clear choice between Newcastle-Ottawa Scale and Appraisal Tool for Cross-Sectional Studies to assess methodological quality in cross-sectional studies of health-related quality of life and breast cancer. J Clin Epidemiol. 2019; 120:94-103. DOI: 10.1016/j.jclinepi.2019.12.013. View

19.

Liu D, Zhou H, Tao Y, Tan J, Chen L, Huang H . Alzheimer's Disease is Associated with Increased Risk of Osteoporosis: The Chongqing Aging Study. Curr Alzheimer Res. 2013; 13(10):1165-72. DOI: 10.2174/15672050113109990149. View

20.

Zhang Y, Chen C, Liu Y, Rao S, Tan Y, Qian Y . Neuronal Induction of Bone-Fat Imbalance through Osteocyte Neuropeptide Y. Adv Sci (Weinh). 2021; 8(24):e2100808. PMC: 8693044. DOI: 10.1002/advs.202100808. View