Zhang Xiaowen, Hsu Warrington W Q, Sing Chor-Wing, Li Gloria H Y, Tan Kathryn C B, Kung Annie W C, Wong Janus S H, Wong Ian Chi-Kei, Cheung Ching-Lung
Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Pak Shek Kok, Hong Kong Special Administrative Region, China.
J Am Med Dir Assoc. 2022 Oct;23(10):1719.e9-1719.e19. doi: 10.1016/j.jamda.2022.07.012. Epub 2022 Aug 18.
Osteoporosis and dementia often coexist, but the association between the 2 diseases remains unclear. This study aimed to investigate the relationship between bone mineral density (BMD) and the risk of incident dementia.
Prospective cohort study, the Hong Kong Osteoporosis Study (HKOS).
Data were from the HKOS and the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong. A total of 5803 participants aged ≥40 years and free of dementia were included in the HKOS.
The baseline BMD at the lumbar spine, femoral neck, trochanter, and total hip were measured using dual-energy x-ray absorptiometry (DXA). The incidence of dementia was identified using their International Classification of Diseases, Ninth Revision, codes. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs.
The median follow-up time of the HKOS was 16.8 years. Higher BMD T scores at the lumbar spine, trochanter, and total hip were significantly associated with the reduced risk of dementia with the respective HR of 0.85 (95% CI 0.76-0.95; P = .004), 0.78 (95% CI 0.68-0.90; P < .001), and 0.82 (95% CI 0.72-0.93; P = .003). The subgroup analyses showed that associations were significant in women but not in men, whereas the associations were unaltered after adjusting for serum estradiol.
Low BMD was associated with an increased risk of dementia, particularly in women. Future studies evaluating the clinical usefulness of BMD on dementia prediction and management are warranted.
骨质疏松症和痴呆症常并存，但这两种疾病之间的关联仍不明确。本研究旨在调查骨密度（BMD）与新发痴呆症风险之间的关系。
前瞻性队列研究，即香港骨质疏松症研究（HKOS）。
数据来自香港骨质疏松症研究（HKOS）和香港临床数据分析与报告系统（CDARS）。香港骨质疏松症研究共纳入了5803名年龄≥40岁且无痴呆症的参与者。
采用双能X线吸收法（DXA）测量腰椎、股骨颈、大转子和全髋的基线骨密度。使用国际疾病分类第九版编码确定痴呆症的发病率。采用Cox比例风险模型估计风险比（HRs）和95%置信区间（CIs）。
香港骨质疏松症研究的中位随访时间为16.8年。腰椎、大转子和全髋较高的骨密度T值与痴呆症风险降低显著相关，其相应的HR分别为0.85（95%CI 0.76 - 0.95；P = 0.004）、0.78（95%CI 0.68 - 0.90；P < 0.001）和0.82（95%CI 0.72 - 0.93；P = 0.003）。亚组分析显示，这种关联在女性中显著，而在男性中不显著，并且在调整血清雌二醇后这种关联未改变。
低骨密度与痴呆症风险增加相关，尤其是在女性中。有必要开展进一步研究评估骨密度在痴呆症预测和管理方面的临床实用性。
