Bone Loss and Osteoporosis are Associated with Conversion from Mild Cognitive Impairment to Alzheimer’s Disease
Abstract
Objective The aim of this study was to analyze the relationship between low bone mineral density (BMD) and conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia in a Chinese cohort. Methods Men and women (n=946) aged 60-75 underwent a dual X-ray absorptiometry (DXA) study of the lumbar spine and hip and were followed annually for 5 years. Their cognitive and functional status were assessed using the Chinese version of the Mini-Mental State Examination (MMSE) and an assessment of the instrumental activities of daily living (ADL). Results There was a positive relationship between osteoporosis and a decline in cognition and function (P Conclusions Osteoporosis was associated with an increased risk of incident AD dementia. Additionally, low BMD at baseline was associated with an increased risk of AD in both women and men.
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Bone loss is frequently detected early in the progression of AD, preceding substantial cognitive decline.
“Patients with osteoporosis often have a higher incidence of AD, and bone loss is frequently detected early in the progression of AD, preceding substantial cognitive decline25–27.”
From Serum amyloid P secreted by bone marrow adipocytes drives skeletal amyloidosis (2025) · cites this paper as [27]
Patients with osteoporosis often have a higher incidence of AD.
“Patients with osteoporosis often have a higher incidence of AD, and bone loss is frequently detected early in the progression of AD, preceding substantial cognitive decline25–27.”
From Serum amyloid P secreted by bone marrow adipocytes drives skeletal amyloidosis (2025) · cites this paper as [27]
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“Osteoporosis is associated with an increased risk of the incidence of Alzheimer's disease dementia [73].”
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“Low BMD values have been suggested to predict a faster and more severe rate of cognitive decline (Zhou et al., 2014).”
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“Alzheimer’s disease is associated with osteoporosis through an abnormal central serotonergic regulatory pathway [85, 86].”
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“23 24 In the present study, participants in their middle age taking PPIs or calcium showed poorer cognitive performance compared to non-takers.”
Brain-derived extracellular vesicles promote bone-fat imbalance in Alzheimer's disease
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“For example, evidence of osteoporosis is also found in patients with mild cognitive impairment (MCI, an early stage of AD), who are much younger and do not have movement defects [38, 39].”
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“AD is frequently associated with fractures and reduction in bone mineral density, even at early stages of disease when patients are still active [4–6], indicating that AD and osteoporosis may share conserved pathogenic mechanisms.”
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“A substantial body of evidence underscores a bidirectional early-stage relationship between cognitive impairment, dementia, and both fragility fractures and low BMD (Albert et al., 2011; Luckhaus et al., 2009; Zhou et al., 2014; Zhao et al., 2023).”
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“lowest quartile of bone density had a 2-fold increased risk of dementia, adding support to the notion that disruption of bone is associated to cognitive and ageing processes [110, 111].”
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“, 2003) and the association of osteoporosis with risk of developing AD (Zhou et al., 2014).”
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“Low BMD and cognitive impairment share several common risk factors, and previous studies found an association of osteoporosis with stroke, brain atrophy, brain white matter changes, and silent infarcts [4–6]; also, it has been reported that low BMD and cognitive impairment often coexist, and that osteoporosis is assoc…”
BackgroundFrom the Mind to the Spine: The Intersecting World of Alzheimer’s and Osteoporosis
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“Similarly, a group in China showed that subjects with mild cognitive impairment (MCI) and low BMD were found to convert to AD at significantly higher rates than those with high BMD [49].”
BackgroundBone-brain crosstalk and potential associated diseases
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Dkk1: A promising molecule to connect Alzheimer's disease and osteoporosis.
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“Growing evidences indicated that people diagnosed with AD have a higher incidence of osteoporosis [5,6].”
BackgroundAlzheimer’s Disease and Its Association With Bone Health: A Case-Control Study
Kumar, S., Chandnani, A., Aung, N. H., Shahid, S., Bukhari, D., Shahzad, S., Kumar, B., & Memon, S. (2021) · Cureus · doi:10.7759/cureus.13772 · Cited by 22 · see citing works
“Similar to our findings, a study conducted in China established a link between osteoporosis and the development of AD; subjects in the lowest quartile of BMD were shown to carry a two-fold increased risk of progression to AD as compared to the healthy population [13].”
ResultEbrahimpur, M., Sharifi, F., Shadman, Z., Payab, M., Mehraban, S., Shafiee, G., Heshmat, R., Fahimfar, N., Mehrdad, N., Khashayar, P., et al. (2020) · Archives of Osteoporosis · doi:10.1007/s11657-020-00817-1 · Cited by 26 · see citing works
Association of Bone Mineral Density and Dementia
Xiao, T., Ghatan, S., Mooldijk, S. S., Trajanoska, K., Oei, L., Gomez, M. M., Ikram, M. K., Rivadeneira, F., & Ikram, M. A. (2023) · Neurology · doi:10.1212/wnl.0000000000207220 · Cited by 48 · see citing works
“Moreover, a Chinese cohort study (n = 946) reported an association between low lumbar spine BMD and increased risks of AD and the conversion from mild cognitive impairment to the onset of dementia.(44) Different findings might result from relatively small sample size, a short follow-up time, or cross-sectional design…”
BackgroundResultMind Gaps and Bone Snaps: Exploring the Connection Between Alzheimer’s Disease and Osteoporosis
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“The study also showed that severe low BMD at baseline was associated with an increased risk of developing AD; this association was seen in both men and women [57].”
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“[37-39] Moreover, patients having MCI and lower BMD values had a double risk for conversion to AD, compared to the controls.[40] In a recent cross-sectional study, along with several common comorbidities, osteoporosis was associated with AD, supporting their co-existence.”
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“Epidemiological studies suggest that reduced areal bone mineral density (BMD) and increased rates of bone loss are associated with cognitive decline and a higher risk of AD (Yaffe et al., 1999; Zhou et al., 2014; Kang et al., 2018; Lv et al., 2018).”
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“15-fold and men had a 2-fold increased risk of AD [4].”
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“In this regard low levels of BMD have been associated with increased rates of progression from mild cognitive impairment to Alzheimer’s disease and with the onset of episodic verbal learning deficit (Zhou et al., 2014; Sohrabi et al., 2015).”
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“Another cohort study also found that osteoporosis was positively associated with cognitive and functional decline and that subjects with BMD values in the lowest quartile had a 2-fold increased risk of AD transition compared to controls (Zhou et al., 2014).”
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“be related to an increased risk of AD (Zhou et al., 2014).”
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“After it was recently revealed that the low bone mineral density would be related to the transition from MCI to Alzheimer disease, there have been many researches related to it (Peng et al., 2016; Zhou et al., 2014).”
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“Similarly, a prospective cohort of 936 individuals followed up for five years demonstrated that those with BMD in the lowest quartile had a two-fold increased risk of transitioning to AD relative to those with higher BMD levels [52].”
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“According to extensive evidence-based evidence, patients with osteoporosis and bone loss often suffer from mild cognitive impairment.(3) Thirdly, lack of nutrition status data.”
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“Eine differenzierte Analyse der Hirnveränderungen ergab eine enge Korrelation zwischen dem Volumen des Hypothalamus, dem Grad der Osteopenie und einer gesteigerten Frakturinzidenz (20, 21).”
Background
- Authors
- Zhou, R., Zhou, H., Rui, L., & Xu, J.
- Affiliations
- Army Medical University (CN)
- Corresponding author
- Xu, Jianzhong
- Venue
- Current Alzheimer Research
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2014-08-12
- Volume
- 11
- Issue
- 7
- Pages
- 706-713
- ISSN
- 1567-2050 (ISSN-L)
- OpenAlex
- W2150839381
- Cited by
- 85
- References
- 0
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 9 · 2023: 11 · 2022: 10 · 2021: 6 · 2020: 8 · 2019: 7 · 2018: 4 · 2017: 1 · 2016: 5 · 2015: 3
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Alzheimer Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- bone mineral density, osteoporosis, bone loss, mild cognitive impairment, Alzheimer's disease, conversion to dementia, cognitive decline, instrumental activities of daily living, sex differences, Chinese older adults
- MeSH terms
- Activities of Daily Living, Aged, Alzheimer Disease, China, Female, Follow-Up Studies, Hip, Humans, Lumbar Vertebrae, Male, Mental Status Schedule, Middle Aged, Osteoporosis, Risk Factors, Cohort Studies, Absorptiometry, Photon, Bone Density, Prevalence, Disease Progression, Asian People, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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