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Osteoporosis and cognitive impairment interwoven warning signs: community-based study on older adults—Bushehr Elderly Health (BEH) Program

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Abstract

Summary

Cognitive impairment and osteoporosis are frequently seen to coincide in clinical practice. Osteoporosis was higher in elderly populations with cognitive impairment, especially in postmenopausal women. Thus, prophylaxis for osteoporosis, falls, and fractures should be considered as part of the treatment of patients with cognitive impairment.

Introduction

Cognitive impairment and osteoporosis are two important health concerns among older adults that their possible relationship, concurrent occurrence, and linking mechanism have recently been highlighted. The purpose of this study was to assess the sex-independent association of these two conditions.

Materials and methods

From among 2331 individuals aged ≥ 60 years selected in Bushehr Elderly Health (BEH) Program, Iran; data of 1508 participants were analyzed. Cognitive status was assessed using Category Fluency Test and Mini-cog assessment instrument. Association between osteopenia–osteoporosis and cognitive impairment were assessed using uni- and multivariable logistic regression models.

Results

Osteoporosis was diagnosed in 598 (39.6%) of the participants (58.3% female and 21.9% male, P < 0.001). From among them, 677 (44.9%) had evidence of cognitive impairment (64.5% female and 31.0% male, P < 0.001). Multivariate logistic regressions showed spinal and total hip osteoporosis was associated with 1.83 (CI 95% 1.13–2.96) and 2.24-fold (CI 95% 1.28–3.89) increase in the risk of cognitive impairment among female subjects, respectively. Ordinal logistic regression, on the other hand, revealed cognitive impairment to be associated with 1.42-fold (CI 95% 1.04–1.92) increase in the risk of spinal osteopenia–osteoporosis, 1.5-fold increase in total hip osteoporosis (CI 95% 1.09–2.05), and 1.48-fold increase in general osteoporosis (CI 95% 1.06–2.0).

Conclusion

Different degrees of bone loss and cognitive impairment may be a risk factor for each other among women but not in men. It is suggested that the screening, adopting preventive measures for the other condition and regular follow-ups, if needed, could be of utmost importance.

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Acknowledgments

The authors would like to express their gratefulness to the staff and researchers of the Bushehr Elderly Health program for their thoughtful contribution.

Author information

Authors and Affiliations

  1. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Mahbube Ebrahimpur & Bagher Larijani

  2. Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Mahbube Ebrahimpur, Farshad Sharifi, Zhaleh Shadman & Neda Mehrdad

  3. Metabolomics and genomics research center, endocrinology and metabolism molecular- cellular sciences institute, Tehran university of medical sciences, Tehran, Iran

    Moloud Payab

  4. Medical Student, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Saghar Mehraban

  5. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Gita Shafiee & Ramin Heshmat

  6. Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Noushin Fahimfar & Afshin Ostovar

  7. Center for Microsystems Technology, Imec and Ghent University, Ghent, Belgium

    Patricia Khashayar

  8. The Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran

    Iraj Nabipour

Authors
  1. Mahbube Ebrahimpur
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  2. Farshad Sharifi
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  11. Iraj Nabipour
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Corresponding author

Correspondence to Afshin Ostovar.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethical Research Committee (ERC) of Endocrinology and Metabolism Research Institute, which is affiliated to Tehran University of Medical Sciences and the ERC of Bushehr University of Medical Sciences.

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Ebrahimpur, M., Sharifi, F., Shadman, Z. et al. Osteoporosis and cognitive impairment interwoven warning signs: community-based study on older adults—Bushehr Elderly Health (BEH) Program. Arch Osteoporos 15, 140 (2020). https://doi.org/10.1007/s11657-020-00817-1

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