Lu Jun, Mastaglia Frank, Tai Andrew Chi Pang, Bulsara Max K, Blakeney William G, Inderjeeth Charles A, Zheng Minghao, Yuan Jun
Perron Institute for Neurological and Translational Science, University of Western Australia, 8 Verdun St, Nedlands, WA, 6009, Australia.
Centre for Translational Orthopaedic Research, School of Biomedical Sciences, University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia.
Aging Clin Exp Res. 2025 Jul 16;37(1):217. doi: 10.1007/s40520-025-03100-w.
Osteoporosis and dementia are two common disorders mainly affecting ageing population, and heel estimated bone mineral density (eBMD) measured by quantitative ultrasound (QUS) has been demonstrated to be a reliable and non-invasive method for assessing skeletal health. The aim of this study is to determine the association between eBMD and incident dementia in older adults.
This retrospective cohort study employs UK Biobank data of 131,030 adults aged ≥ 60 years without dementia at baseline. Cox proportional-hazards models were used to investigate the association between eBMD and incident dementia, with the C-index evaluating the discriminative potential of eBMD.
Among participants (52.1% women, median [IQR] age was 64 [62-66] years), there were 4,572 cases (3.5%) of incident dementia. Minimal model showed that participants with low eBMD (< 0.467 g/cm) had a 14% increase in the rate of dementia incidence (HR 1.14, 95% CI 1.06-1.23; P <.001), and each standard deviation (SD) decrease in eBMD was associated with a 49% increase in dementia risk (HR 1.49, 95% CI 1.19-1.86; P <.001). Such association remained significant after further adjustment for potential confounders. Stratified analyses revealed that lower eBMD increased dementia risk in male participants (HR 1.17, 95% CI 1.06-1.31; P =.003) and in participants with neutral (HR 1.18, 95% CI 1.05-1.33; P =.007) or low genetic risk (HR 1.36, 95% CI 1.01-1.83; P =.04). Sensitivity analyses showed similar results. However, discriminative analyses showed minimal improvement after adding eBMD to dementia prediction models.
Lower heel eBMD is independently associated with increased dementia risk among older adults.
骨质疏松症和痴呆症是主要影响老年人群的两种常见疾病，通过定量超声（QUS）测量的足跟估计骨密度（eBMD）已被证明是评估骨骼健康的一种可靠且非侵入性的方法。本研究的目的是确定老年人中eBMD与新发痴呆症之间的关联。
这项回顾性队列研究采用了英国生物银行中131,030名年龄≥60岁且基线时无痴呆症的成年人的数据。使用Cox比例风险模型来研究eBMD与新发痴呆症之间的关联，C指数用于评估eBMD的判别潜力。
在参与者中（52.1%为女性，年龄中位数[四分位间距]为64[62 - 66]岁），有4,572例（3.5%）新发痴呆症病例。最小模型显示，eBMD低（<0.467 g/cm）的参与者痴呆症发病率增加14%（风险比1.14，95%置信区间1.06 - 1.23；P <.001），eBMD每降低一个标准差（SD），痴呆症风险增加49%（风险比1.49，95%置信区间1.19 - 1.86；P <.001）。在进一步调整潜在混杂因素后，这种关联仍然显著。分层分析显示，较低的eBMD增加了男性参与者（风险比1.17，95%置信区间1.06 - 1.31；P =.003）以及遗传风险为中性（风险比1.18，95%置信区间1.05 - 1.33；P =.007）或低遗传风险（风险比1.36，95%置信区间1.01 - 1.83；P =.04）的参与者患痴呆症的风险。敏感性分析显示了类似结果。然而，判别分析表明，在痴呆症预测模型中加入eBMD后，判别能力的改善很小。
较低的足跟eBMD与老年人痴呆症风险增加独立相关。
