Bone mineral density; Cognitive impairment; Dementia; Epidemiology; Fracture; Osteoporosis; Aged; Humans; Aging/metabolism; Bone and Bones/metabolism; Bone Density; Risk Factors; Cognitive Dysfunction/epidemiology; Cognitive Dysfunction/metabolism; Dementia/epidemiology; Dementia/metabolism; Osteoporosis/epidemiology; Osteoporosis/metabolism; Aging; Bone and Bones; Cognitive Dysfunction; Geriatrics and Gerontology
Abstract :
[en] Mild cognitive impairment, dementia and osteoporosis are common diseases of ageing and, with the increasingly ageing global population, are increasing in prevalence. These conditions are closely associated, with shared risk factors, common underlying biological mechanisms and potential direct causal pathways. In this review, the epidemiological and mechanistic links between mild cognitive impairment, dementia and skeletal health are explored. Discussion will focus on how changes in brain and bone signalling can underly associations between these conditions, and will consider the molecular and cellular drivers in the context of inflammation and the gut microbiome. There is a complex interplay between nutritional changes, which may precede or follow the onset of mild cognitive impairment (MCI) or dementia, and bone health. Polypharmacy is common in patients with MCI or dementia, and there are difficult prescribing decisions to be made due to the elevated risk of falls associated with many drugs used for associated problems, which can consequently increase fracture risk. Some medications prescribed for cognitive impairment may directly impact bone health. In addition, patients may have difficulty remembering medication without assistance, meaning that osteoporosis drugs may be prescribed but not taken. Cognitive impairment may be improved or delayed by physical activity and exercise, and there is evidence for the additional benefits of physical activity on falls and fractures. Research gaps and priorities with the aim of reducing the burden of osteoporosis and fractures in people with MCI or dementia will also be discussed.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Curtis, Elizabeth M ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK ; NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
Miguel, Mario ; Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
McEvoy, Claire ; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
Ticinesi, Andrea ; Department of Medicine and Surgery, University of Parma, Parma, Italy ; Azienda Ospedaliero-Universitaria Di Parma, Parma, Italy
Torre, Carla ; Faculdade de Farmácia, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisbon, Portugal ; Laboratory of Systems Integration Pharmacology, Clinical and Regulatory Science, Research Institute for Medicines of the University of Lisbon (iMED.ULisboa), Avenida Professor Gama Pinto, 1649-003, Lisbon, Portugal
Al-Daghri, Nasser; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Kingdom of Saudi Arabia
Alokail, Majed; Biochemistry Department, College of Science, KSU, Riyadh, Kingdom of Saudi Arabia
Bałkowiec-Iskra, Ewa ; Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland ; The Office for Registration of Medicinal Products, Medical Devices and Biocidal Products & CHMP, SAWP, CNSWP, PCWP, ETF (European Medicines Agency) Member, Warsaw, Poland
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Burlet, Nansa ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Cerreta, Francesca; Digital Health and Geriatrics, European Medicines Agency, Amsterdam, The Netherlands
Clark, Patricia ; Clinical Epidemiology Unit, Hospital Infantil Federico Gómez-Facultad de Medicina, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
Cherubini, Antonio ; Geriatria, Accettazione Geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA Istituto Nazionale di Ricovero e Cura per Anziani, Ancona, Italy ; Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
Cooper, Cyrus ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK ; NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
D'Amelio, Patrizia ; Department of Medicine, Service of Geriatric Medicine & Geriatric Rehabilitation, University of Lausanne Hospital, University of Lausanne, Lausanne, Switzerland
Fuggle, Nicholas ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK ; NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
Gregson, Celia ; Musculoskeletal Research Unit, Bristol Medical School, Learning and Research Building, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK ; The Health Research Unit of Zimbabwe (THRU ZIM), The Biomedical Research and Training Institute, Harare, Zimbabwe
Halbout, Philippe; International Osteoporosis Foundation, Nyon, Switzerland
Kanis, John A ; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia ; Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
Kaufman, Jean; Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
Laslop, Andrea ; Scientific Office, Austrian Medicines and Medical Devices Agency, Vienna, Austria
Maier, Andrea ; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117596, Singapore ; Department of Human Movement Sciences, at AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
Matijevic, Radmila ; Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia
McCloskey, Eugene ; Mellanby Centre for Musculoskeletal Research, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK ; MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK
Ormarsdóttir, Sif; Medicine Assessment and Licencing, Icelandic Medicines Agency, Reykjavik, Iceland
Yerro, Concha Prieto; Agencia Española de Medicamentos y Productos Sanitarios, Madrid, Spain
Radermecker, Régis ; Université de Liège - ULiège > Département des sciences cliniques > Pharmacologie clinique
Rolland, Yves ; HealthAge, CHU Toulouse, CERPOP UMR 1295, Inserm, Université Paul Sabatier, Toulouse, France
Singer, Andrea ; Departments of Obstetrics & Gynecology and Medicine, MedStar Georgetown University Hospital, Washington, DC, USA
Veronese, Nicola ; Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
Rizzoli, René ; Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique ; Protein Research Chair, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
Harvey, Nicholas C ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK. nch@mrc.soton.ac.uk ; NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK. nch@mrc.soton.ac.uk
The ESCEO Working Group was funded by the ESCEO. The ESCEO receives unrestricted educational grants to support its educational and scientific activities from non-governmental organisations, not-for-profit organisations, non-commercial or corporate partners. The choice of topics, participants, content and agenda of the Working Groups as well as the writing, editing, submission and reviewing of the manuscript are the sole responsibility of the ESCEO, without any influence from third parties. This work was supported by the Distinguished Scientist Fellowship Program (DSFP) of the King Saud University, Riyadh, Kingdom of Saudi Arabia. NCH, EMC, NRF, CC are supported by the UK Medical Research Council (MRC) [MC_PC_21003; MC_PC_21001], National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton, and University Hospital Southampton NHS Foundation Trust, UK. CLG is funded by the National Institute for Health and Care Research (NIHR302394). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
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