Skip to main content

Advertisement

SpringerLink
Log in

Osteoporotic fractures: A brain or bone disease?

  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Osteoporosis is a skeletal disorder that predisposes individuals to increased risk of fracture. However, most osteoporotic fractures occur in women who do not meet criteria for osteoporosis. Hence, bone density, by itself, is a relatively poor predictor of fracture. Age and age-related factors are now recognized as increasingly important in determining fracture risk. Osteoporotic fractures are associated with increased disability and mortality, suggesting that osteoporosis may be a clinical manifestation of an underlying disease process affecting multiple systems. The systems affected, the musculoskeletal system and the central nervous system, are shared in many respects with the frailty syndrome. Vitamin D deficiency is a major contributor to the frailty syndrome, osteoporosis, and osteoporotic fractures. Its effects are mediated by the development of cerebrovascular disease, postural instability, muscle weakness, and bone fragility. Thus, osteoporotic fractures result from both a bone and brain disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Melton LJ 3rd, Lane AW, Cooper C, et al.: Prevalence and incidence of vertebral deformities. Osteoporos Int 1993, 3:113–119.

    Article  PubMed  Google Scholar 

  2. Lindsay R, Silverman SL, Cooper C, et al.: Risk of new vertebral fracture in the year following a fracture. JAMA 2001, 285:320–323.

    Article  PubMed  CAS  Google Scholar 

  3. Birge SJ, Morrow-Howell N, Proctor EK: Hip fracture. Clin Geriatr Med 1994, 10:589–609.

    PubMed  CAS  Google Scholar 

  4. Chandler JM, Zimmerman SI, Girman CJ, et al.: Low bone mineral density and risk of fracture in white female nursing home residents. JAMA 2000, 284:972–977.

    Article  PubMed  CAS  Google Scholar 

  5. Siris ES, Miller PD, Barrett-Connor E, et al.: Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 2001, 286:2815–2822.

    Article  PubMed  CAS  Google Scholar 

  6. Kuo HK, Lipsitz LA: Cerebral white matter changes and geriatric syndromes: is there a link? J Gerontol A Biol Sci Med Sci 2004, 59:818–826.

    PubMed  Google Scholar 

  7. Naessen T, Lindmark B, Larsen HC: Hormone therapy and postural balance in elderly women. Menopause 2007, 14:1020–1024.

    PubMed  Google Scholar 

  8. Zandi PP, Carlson MC, Plassman BL, et al.: Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study. JAMA 2002, 288:2123–2129.

    Article  PubMed  CAS  Google Scholar 

  9. Shaw TG, Mortel KF, Meyer JS, et al.: Cerebral blood flow changes in benign aging and cerebrovascular disease. Neurology 1984, 34:855–862.

    PubMed  CAS  Google Scholar 

  10. Schmidt R, Fazekas F, Reinhart B, et al.: Estrogen replacement therapy in older women: a neuropsychological and brain MRI study. J Am Geriatr Soc 1996, 44:1307–1313.

    PubMed  CAS  Google Scholar 

  11. Robbins J, Aragaki AK, Kooperberg C, et al.: Factors associated with 5-year risk of hip fracture in postmenopausal women. JAMA 2007, 298:2389–2398.

    Article  PubMed  CAS  Google Scholar 

  12. Birge SJ: Osteoporosis and hip fracture. Clin Geriatr Med 1993, 9:69–86.

    PubMed  CAS  Google Scholar 

  13. Cummings SR, Black DM, Rubin SM: Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 1989, 149:2445–2448.

    Article  PubMed  CAS  Google Scholar 

  14. Melton LJ 3rd, Kan SH, Wahner HW, Riggs BL: Lifetime fracture risk: an approach to hip fracture risk assessment based on bone mineral density and age. J Clin Epidemiol 1988, 41:985–994.

    Article  PubMed  Google Scholar 

  15. Yeudall LT, Reddon JR, Gill DM, Stefanyk WO: Normative data for the Halstead-Reitan neuropsychological tests stratified by age and sex. J Clin Psychol 1987, 43:346–367.

    Article  PubMed  CAS  Google Scholar 

  16. Junque C, Pujol J, Vendrell P, et al.: Leuko-araiosis on magnetic resonance imaging and speed of mental processing. Arch Neurol 1990, 47:151–156.

    PubMed  CAS  Google Scholar 

  17. Ball LJ, Bisher GB, Birge SJ: A simple test of central processing speed: an extension of the Short Blessed Test. J Am Geriatr Soc 1999, 47:1359–1363.

    PubMed  CAS  Google Scholar 

  18. Nevitt MC, Cummings SR, Hudes ES: Risk factors for injurious falls: a prospective study. J Gerontol 1991, 46:M164–M170.

    PubMed  CAS  Google Scholar 

  19. Baloh RW, Ying SH, Jacobson KM: A longitudinal study of gait and balance dysfunction in normal older people. Arch Neurol 2003, 60:835–839.

    Article  PubMed  Google Scholar 

  20. Faulkner KA, Redfern MS, Cauley JA, et al.: Multitasking: association between poorer performance and a history of recurrent falls. J Am Geriatr Soc 2007, 55:570–576.

    Article  PubMed  Google Scholar 

  21. Camicioli R, Moore MM, Sexton G, et al.: Age-related brain changes associated with motor function in healthy older people. J Am Geriatr Soc 1999, 47:330–334.

    PubMed  CAS  Google Scholar 

  22. Verghese J, Lipton RB, Hall CB, et al.: Abnormality of gait as a predictor of non-Alzheimer’s dementia. N Engl J Med 2002, 347:1761–1768.

    Article  PubMed  Google Scholar 

  23. Robinovitch SN, Hayes WC, McMahon TA: Prediction of femoral impact forces in falls on the hip. J Biomech Eng 1991, 113:366–374.

    Article  PubMed  CAS  Google Scholar 

  24. Michelon E, Blaum C, Semba RD, et al.: Vitamin and carotenoid status in older women: associations with the frailty syndrome. J Gerontol A Biol Sci Med Sci 2006, 61:600–607.

    PubMed  Google Scholar 

  25. Muller K, Haahr PM, Diamant M, et al.: 1,25-Dihydroxyvitamin D3 inhibits cytokine production by human blood monocytes at the post-transcriptional level. Cytokine 1992, 4:506–512.

    Article  PubMed  CAS  Google Scholar 

  26. Kiraly SJ, Kiraly MA, Hawe RD, Makhani N: Vitamin D as a neuroactive substance: review. Scientific World Journal 2006, 6:125–139.

    PubMed  CAS  Google Scholar 

  27. Wilkins CH, Sheline YI, Roe CM, et al.: Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry 2006, 14:1032–1040.

    Article  PubMed  Google Scholar 

  28. Boland R: Role of vitamin D in skeletal muscle function. Endocr Rev 1986, 7:434–448.

    Article  PubMed  CAS  Google Scholar 

  29. Nilsson K, Gustafson L, Hultberg B: Improvement of cognitive functions after cobalamin/folate supplementation in elderly patients with dementia and elevated plasma homocysteine. Int J Geriatr Psychiatry 2001, 16:609–614.

    Article  PubMed  CAS  Google Scholar 

  30. Chapuy MC, Arlot ME, Duboeuf F, et al.: Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 1992, 327:1637–1642.

    PubMed  CAS  Google Scholar 

  31. van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, et al.: Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004, 350:2033–2041.

    Article  PubMed  Google Scholar 

  32. Bischoff HA, Stahelin HB, Dick W, et al.: Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 2003, 18:343–351.

    Article  PubMed  CAS  Google Scholar 

  33. Sato Y, Honda Y, Iwamoto J, et al.: Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 2005, 293:1082–1088.

    Article  PubMed  CAS  Google Scholar 

  34. Liu-Ambrose T, Eng JJ, Khan KM, et al.: Older women with osteoporosis have increased postural sway and weaker quadriceps strength than counterparts with normal bone mass: overlooked determinants of fracture risk? J Gerontol A Biol Sci Med Sci 2003, 58:M862–M866.

    PubMed  Google Scholar 

  35. Lui LY, Stone K, Cauley JA, et al.: Bone loss predicts subsequent cognitive decline in older women: the study of osteoporotic fractures. J Am Geriatr Soc 2003, 51:38–43.

    Article  PubMed  Google Scholar 

  36. Tan ZS, Seshadri S, Beiser A, et al.: Bone mineral density and the risk of Alzheimer disease. Arch Neurol 2005, 62:107–111.

    Article  PubMed  Google Scholar 

  37. Munir J, Birge SJ: Vitamin D deficiency in pre-and postmenopausal women. Menopausal Health 2008 (in press).

  38. Parker MJ, Gillespie LD, Gillespie WJ: Hip protectors for preventing hip fractures in the elderly. Cochrane Database Syst Rev 2004, 3:CD001255.

Download references

Author information

Authors and Affiliations

  1. Division of Geriatrics and Nutritional Science, Washington University School of Medicine, 4488 Forest Park Boulevard, St. Louis, MO, 63108, USA

    Stanley J. Birge

Authors
  1. Stanley J. Birge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stanley J. Birge.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Birge, S.J. Osteoporotic fractures: A brain or bone disease?. Curr Osteoporos Rep 6, 57–61 (2008). https://doi.org/10.1007/s11914-008-0010-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11914-008-0010-z

Keywords

Search

Navigation