Shared risk factors may drive cognitive decline and bone los
Cognitive decline and osteoporosis often coexist and some evidence suggests a causal link. However, there are no data on the longitudinal relationship between cognitive decline, bone loss and fracture risk, independent of aging.

This study aimed to determine the association between: (i) cognitive decline and bone loss; and (ii) clinically significant cognitive decline (more than 3 points) on Mini Mental State Examination (MMSE) over the first 5?years and subsequent fracture risk over the following 10?years. A total of 1741 women and 620 men aged more than 65?years from the population-based Canadian Multicentre Osteoporosis Study were followed from 1997 to 2013.

Association between cognitive decline and (i) bone loss was estimated using mixed-effects models; and (ii) fracture risk was estimated using adjusted Cox models. Over 95% of participants had normal cognition at baseline (MMSE?more than?24). The annual % change in MMSE was similar for both genders. After multivariable adjustment, cognitive decline was associated with bone loss in women (6.5% for each percent decline in MMSE from baseline) but not men.

Approximately 13% of participants experienced significant cognitive decline by year 5. In women, fracture risk was increased significantly. There were too few men to analyze. There was a significant association between cognitive decline and both bone loss and fracture risk, independent of aging, in women. Further studies are needed to determine mechanisms that link these common conditions.