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Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis

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Abstract

Osteoporosis is a common systemic skeletal disease that predominantly affects people older than 50 years and often co-occurs with dementia. The purpose of this study was to evaluate the risk of dementia in osteoporosis patients in Taiwan. Using data from Taiwan's National Health Insurance Research Database (NHIRD), we identified 23,941 patients with osteoporosis from 2000 to 2010 and 47,579 nonosteoporosis control patients, frequency-matched for age, sex, and index year, excluding patients with dementia at the baseline. We conducted univariate and multiple Cox proportional-hazards regression analyses to calculate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of the association between osteoporosis and risk of dementia. After adjustment for potential risk factors, the osteoporosis patients exhibited 1.46-fold and 1.39-fold higher risk of dementia (95 % CI = 1.37–1.56) and Alzheimer's disease (95 % CI = 0.95–2.02), respectively, compared with the matched nonosteoporosis patients. We observed increased risk of dementia in both men and women with osteoporosis. The osteoporosis patients receiving bisphosphonate treatment or estrogen supplementation were associated with significantly lower risk of dementia compared with the osteoporosis patients who did not receive any treatment. Overall, our results suggest higher risks of dementia in osteoporosis patients than in nonosteoporosis patients. Osteoporosis could thus be considered an early risk factor for dementia. Future large-scale double-blind randomized clinical trials are required to clarify the role of medication in osteoporosis-related dementia.

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Acknowledgments

This study was supported by grants from the study hospital (DMR-102-014 and DMR-102-023), the Taiwan Department of Health Clinical Trial and Research Center and for Excellence (DOH102-TD-B-111-004), the Taiwan Department of Health Cancer Research Center for Excellence (DOH102-TD-C-111-005), and the International Research-Intensive Centers of Excellence in Taiwan (I-RiCE) (NSC101-2911-I-002-303).

Conflict of interest

The authors declare that they have no conflicts of interest.

Author contributions

Conception and design: Kuang-Hsi Chang, Chia-Hung Kao. Administrative support: Cheng-Li Lin, Fung-Chang Sung, Chi-Jung Chung, Trong-Neng Wu. Collection and assembly of data: Kuang-Hsi Chang, Cheng-Li Lin, Chi-Jung Chung, Chia-Hung Kao. Data analysis and interpretation: Kuang-Hsi Chang, Chi-Jung Chung, Chia-Hung Kao. Manuscript preparation: All authors. Final approval of manuscript: All authors.

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Authors and Affiliations

  1. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan

    Kuang-Hsi Chang

  2. Department of Public Health, China Medical University, Taichung, Taiwan

    Kuang-Hsi Chang, Fung-Chang Sung & Trong-Neng Wu

  3. Department of Medical Research, China Medical University and Hospital, Taichung, Taiwan

    Chi-Jung Chung

  4. Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan

    Chi-Jung Chung

  5. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin

  6. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    Chia-Hung Kao

  7. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Number 2, Yuh-Der Road, Taichung, 40447, Taiwan

    Chia-Hung Kao

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  1. Kuang-Hsi Chang
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  2. Chi-Jung Chung
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Corresponding author

Correspondence to Chia-Hung Kao.

Additional information

K.-H. Chang and C.-J. Chung contributed equally to this work.

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Chang, KH., Chung, CJ., Lin, CL. et al. Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis. AGE 36, 967–975 (2014). https://doi.org/10.1007/s11357-013-9608-x

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  • DOI: https://doi.org/10.1007/s11357-013-9608-x

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