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Association Between Bone Mineral Density and Cognitive Decline in Older Women
Author(s) -
Yaffe Kristine,
Browner Warren,
Cauley Jane,
Launer Lenore,
Harris Tamara
Publication year - 1999
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1999.tb05196.x
Subject(s) - medicine , osteoporosis , bone mineral , odds ratio , prospective cohort study , bone density , cognition , cognitive decline , cohort , gerontology , physical therapy , dementia , psychiatry , disease
OBJECTIVE: To test the hypothesis that bone mineral density (BMD), a marker of cumulative estrogen exposure, is associated with cognitive function in nondemented older women. DESIGN: A prospective cohort study. SETTING: Clinical centers in Baltimore, Maryland, Minneapolis, Minnesota, the Monongahela Valley near Pittsburgh, Pennsylvania, and Portland, Oregon. PARTICIPANTS: We evaluated 8333 older community‐dwelling women enrolled in the Study of Osteoporotic Fractures who were not taking estrogen replacement. MEASUREMENTS: Calcaneal and hip BMD were measured at baseline and at follow‐up (4–6 years later);vertebral fractures were ascertained radiologically at year 6. Women were administered a modified Mini‐Mental State Exam, Trails B, and Digit Symbol at baseline and at follow‐up. RESULTS: Compared with women with higher bone mineral density, women with low baseline BMD had up to 8% worse baseline cognitive scores (P = .001) and up to 6% worse repeat cognitive scores (P = .001), even after multivariate adjustments. For 1 SD decrease in baseline hip BMD or calcaneal BMD, women had a 32% (95% CI, 19–47%) or a 33% (95% CI, 20–48%) greater odds of cognitive deterioration (worst 10th percentile of change). Women with vertebral fractures had lower cognitive test scores and a greater odds of cognitive deterioration than those without fractures (OR = 1.29; 95%CI, 1.03‐1.60). CONCLUSIONS: Women with osteoporosis, whether measured by baseline BMD, reductions in BMD, or vertebral fractures, have poorer cognitive function and greater risk of cognitive deterioration. Our findings suggest a link between two of the most common conditions affecting older women. Further understanding of this association may be important for new treatment and prevention directions. J Am Geriatr Soc 47:1176‐1182,1999.