Bio |
Department of Psychiatry, University of California, San
Francisco, San Francisco Veterans Affairs Medical Center 94121,
USA. |
| Abstract |
OBJECTIVE: To test the hypothesis that bone mineral density
(BMD), a marker of cumulative estrogen exposure, is associated
with cognitive function in nondemented older women. DESIGN: A
prospective cohort study. SETTING: Clinical centers in Baltimore,
Maryland, Minneapolis, Minnesota, the Monongahela Valley near
Pittsburgh, Pennsylvania, and Portland, Oregon. PARTICIPANTS: We
evaluated 8333 older community-dwelling women enrolled in the
Study of Osteoporotic Fractures who were not taking estrogen
replacement. MEASUREMENTS: Calcaneal and hip BMD were measured at
baseline and at follow-up (4-6 years later); vertebral fractures
were ascertained radiologically at year 6. Women were administered
a modified Mini-Mental State Exam, Trails B, and Digit Symbol at
baseline and at follow-up. RESULTS: Compared with women with
higher bone mineral density, women with low baseline BMD had up to
8% worse baseline cognitive scores (P = .001) and up to 6% worse
repeat cognitive scores (P = .001), even after multivariate
adjustments. For 1 SD decrease in baseline hip BMD or calcaneal
BMD, women had a 32% (95% CI, 19-47%) or a 33% (95% CI, 20-48%)
greater odds of cognitive deterioration (worst 10th percentile of
change). Women with vertebral fractures had lower cognitive test
scores and a greater odds of cognitive deterioration than those
without fractures (OR = 1.29; 95% CI, 1.03-1.60). CONCLUSIONS:
Women with osteoporosis, whether measured by baseline BMD,
reductions in BMD, or vertebral fractures, have poorer cognitive
function and greater risk of cognitive deterioration. Our findings
suggest a link between two of the most common conditions affecting
older women. Further understanding of this association may be
important for new treatment and prevention directions. PMID:
10522949 [PubMed - indexed for MEDLINE]
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