Jang Min Uk, Kwon Young-Min, Hwang Jihyun, Choi Go Woon, Kim Min Seong, Lee Dong I, Jo Sang Won, Kim Sung Jae
NV Brain Neurology Clinic, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea.
J Clin Med. 2025 Jan 7;14(2):300. doi: 10.3390/jcm14020300.
: Alzheimer's disease (AD) is the most common neurodegenerative disease in the older adult population and is often associated with reduced physical activity. Reduced activity and mechanical loading subsequently reduce bone mineral density and increase risk of osteoporosis. Bisphosphonates (BPs) offer preventative effects on osteoporotic fractures in the general population, but their effects on patients with AD are less known. This study aimed to assess the impact of BPs on osteoporotic fractures and survival in patients with AD. : In this nationwide retrospective cohort study, 43,469 patients from the Korea National Health Insurance Service database between 2004 and 2018 were included. All patients were diagnosed with AD and subsequently diagnosed with osteoporosis. Continuous use of BPs was defined as having prescriptions for BP medications one year after the diagnosis of osteoporosis. Propensity score matching paired 12,519 BP users with 12,518 non-users for post-fracture survival analysis. : Continuous use of BPs showed a significant preventative effect on the Cox regression model [hazard ratio (HR), 0.890-0.895; < 0.001] but not on the logistic regression model. The occurrence of osteoporotic fractures in the hip or spine significantly increased the risk of death [hip, HR, 2.036; 95% confidence interval (CI), 1.789-2.316; < 0.001; spine, HR, 1.465; CI, 1.305-1.644; < 0.001]. : Continuous use of BPs was associated with reduced occurrence of osteoporotic fractures in patients with AD. Patients with AD showed significantly higher mortality rates after the occurrence of osteoporotic fractures. Further studies with detailed patient characteristics and compliance are warranted.
阿尔茨海默病（AD）是老年人群中最常见的神经退行性疾病，常与身体活动减少有关。活动减少和机械负荷降低随后会降低骨密度并增加骨质疏松症的风险。双膦酸盐（BPs）对普通人群的骨质疏松性骨折具有预防作用，但其对AD患者的影响尚鲜为人知。本研究旨在评估BPs对AD患者骨质疏松性骨折和生存的影响。：在这项全国性回顾性队列研究中，纳入了2004年至2018年间韩国国民健康保险服务数据库中的43469例患者。所有患者均被诊断为AD，随后被诊断为骨质疏松症。BPs的持续使用定义为在骨质疏松症诊断后一年有BP药物处方。倾向评分匹配将12519名BP使用者与12518名非使用者配对进行骨折后生存分析。：BPs的持续使用在Cox回归模型中显示出显著的预防作用[风险比（HR），0.890 - 0.895；<0.001]，但在逻辑回归模型中未显示出预防作用。髋部或脊柱骨质疏松性骨折的发生显著增加了死亡风险[髋部，HR，2.036；95%置信区间（CI），1.789 - 2.316；<0.001；脊柱，HR，1.465；CI，1.305 - 1.644；<0.001]。：BPs的持续使用与AD患者骨质疏松性骨折的发生率降低有关。AD患者在发生骨质疏松性骨折后显示出显著更高的死亡率。有必要对患者的详细特征和依从性进行进一步研究。
