The University of Southampton
University of Southampton Institutional Repository

Impact of dementia and mild cognitive impairment on bone health in older people

Impact of dementia and mild cognitive impairment on bone health in older people
Impact of dementia and mild cognitive impairment on bone health in older people

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.

Aged, Aging/metabolism, Bone Density, Bone and Bones/metabolism, Cognitive Dysfunction/epidemiology, Dementia/epidemiology, Humans, Osteoporosis/epidemiology, Risk Factors, Fracture, Epidemiology, Osteoporosis, Bone mineral density, Cognitive impairment, Dementia
1594-0667
Curtis, Elizabeth M.
6e344d0a-3893-4dd5-88ca-4cad00558cce
Miguel, Mario
cfa653f8-712a-4dd7-b7b4-1ff104e7552b
McEvoy, Claire
b75da83b-683c-4b27-a4d5-725ddac87c42
Ticinesi, Andrea
83f61202-cf81-4932-bf62-de48981d6701
Torre, Carla
962bf7c5-fe7e-455f-a77c-f08bcc9b80fb
Al-Daghri, Nasser
0bf1023c-a104-4f74-8b06-87780dfbd8b4
Alokail, Majed
9adf2d61-d9f7-4095-bc36-701f0680646a
Bałkowiec-Iskra, Ewa
2c0818d4-ac9e-414c-b4b0-5a39b38d1bfb
Bruyère, Olivier
ba727e54-ca17-4fa8-be3d-4729fb4b8c0d
Burlet, Nansa
ac700618-10d2-4a9c-8892-3727ab64c226
Cavalier, Etienne
bc312308-1b70-4434-ab15-28860479d2e9
Cerreta, Francesca
420e2878-0fec-4574-8b3a-ea8b9d95a4dc
Clark, Patricia
191bedee-2fe4-4d85-923e-29a8c6680b67
Cherubini, Antonio
09bc8d13-db3e-46dd-9319-6c0a94638eb8
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
D'Amelio, Patrizia
fe56e95d-4546-4063-819a-f1ad7142b6e5
Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Gregson, Celia
9e28df51-89ec-4a1e-88ff-c6010a986e96
Halbout, Philippe
a6bac6c8-e463-4c0d-bb75-389ad2b0b945
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Kaufman, Jean
a2df82a7-fc7f-4e57-a933-624dc46d08f3
Laslop, Andrea
d6cf9614-e6a6-4409-a5c2-875d66bda941
Maggi, Stefania
57e7e62a-b7dd-4291-82e3-efc8c9a7e12a
Maier, Andrea
b5741769-959b-4030-b823-42dee5e2f935
Matijevic, Radmila
665fb578-0e16-45d4-bad0-92b61db65e2d
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Ormarsdóttir, Sif
f66e4318-e884-4542-bb2a-752dbd0d64ed
Yerro, Concha Prieto
a3973244-637d-4d22-8c57-7daf1cecae2c
Radermecker, Régis P
e38da473-f811-44ee-bee0-7093d0219a68
Rolland, Yves
9ba9e24c-842f-408f-988b-eef4aabbdb78
Singer, Andrea
0aefe63e-d7f8-4720-9323-1e248337f396
Veronese, Nicola
c4539c05-e941-46d2-8683-b7c9dc09b211
Rizzoli, René
c1190577-8164-471d-b90f-6959f92bc25e
Reginster, Jean-Yves
33684a35-87f7-4b8d-bb91-4da2b809f855
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Curtis, Elizabeth M.
6e344d0a-3893-4dd5-88ca-4cad00558cce
Miguel, Mario
cfa653f8-712a-4dd7-b7b4-1ff104e7552b
McEvoy, Claire
b75da83b-683c-4b27-a4d5-725ddac87c42
Ticinesi, Andrea
83f61202-cf81-4932-bf62-de48981d6701
Torre, Carla
962bf7c5-fe7e-455f-a77c-f08bcc9b80fb
Al-Daghri, Nasser
0bf1023c-a104-4f74-8b06-87780dfbd8b4
Alokail, Majed
9adf2d61-d9f7-4095-bc36-701f0680646a
Bałkowiec-Iskra, Ewa
2c0818d4-ac9e-414c-b4b0-5a39b38d1bfb
Bruyère, Olivier
ba727e54-ca17-4fa8-be3d-4729fb4b8c0d
Burlet, Nansa
ac700618-10d2-4a9c-8892-3727ab64c226
Cavalier, Etienne
bc312308-1b70-4434-ab15-28860479d2e9
Cerreta, Francesca
420e2878-0fec-4574-8b3a-ea8b9d95a4dc
Clark, Patricia
191bedee-2fe4-4d85-923e-29a8c6680b67
Cherubini, Antonio
09bc8d13-db3e-46dd-9319-6c0a94638eb8
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
D'Amelio, Patrizia
fe56e95d-4546-4063-819a-f1ad7142b6e5
Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Gregson, Celia
9e28df51-89ec-4a1e-88ff-c6010a986e96
Halbout, Philippe
a6bac6c8-e463-4c0d-bb75-389ad2b0b945
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Kaufman, Jean
a2df82a7-fc7f-4e57-a933-624dc46d08f3
Laslop, Andrea
d6cf9614-e6a6-4409-a5c2-875d66bda941
Maggi, Stefania
57e7e62a-b7dd-4291-82e3-efc8c9a7e12a
Maier, Andrea
b5741769-959b-4030-b823-42dee5e2f935
Matijevic, Radmila
665fb578-0e16-45d4-bad0-92b61db65e2d
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Ormarsdóttir, Sif
f66e4318-e884-4542-bb2a-752dbd0d64ed
Yerro, Concha Prieto
a3973244-637d-4d22-8c57-7daf1cecae2c
Radermecker, Régis P
e38da473-f811-44ee-bee0-7093d0219a68
Rolland, Yves
9ba9e24c-842f-408f-988b-eef4aabbdb78
Singer, Andrea
0aefe63e-d7f8-4720-9323-1e248337f396
Veronese, Nicola
c4539c05-e941-46d2-8683-b7c9dc09b211
Rizzoli, René
c1190577-8164-471d-b90f-6959f92bc25e
Reginster, Jean-Yves
33684a35-87f7-4b8d-bb91-4da2b809f855
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145

Curtis, Elizabeth M., Miguel, Mario, McEvoy, Claire, Ticinesi, Andrea, Torre, Carla, Al-Daghri, Nasser, Alokail, Majed, Bałkowiec-Iskra, Ewa, Bruyère, Olivier, Burlet, Nansa, Cavalier, Etienne, Cerreta, Francesca, Clark, Patricia, Cherubini, Antonio, Cooper, Cyrus, D'Amelio, Patrizia, Fuggle, Nicholas, Gregson, Celia, Halbout, Philippe, Kanis, John A., Kaufman, Jean, Laslop, Andrea, Maggi, Stefania, Maier, Andrea, Matijevic, Radmila, McCloskey, Eugene, Ormarsdóttir, Sif, Yerro, Concha Prieto, Radermecker, Régis P, Rolland, Yves, Singer, Andrea, Veronese, Nicola, Rizzoli, René, Reginster, Jean-Yves and Harvey, Nicholas C. (2025) Impact of dementia and mild cognitive impairment on bone health in older people. Aging Clinical and Experimental Research, 37 (1). (doi:10.1007/s40520-024-02871-y).

Record type: Article

Abstract

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.

Text
s40520-024-02871-y - Version of Record
Available under License Creative Commons Attribution.
Download (1MB)

More information

Accepted/In Press date: 20 October 2024
Published date: 27 December 2025
Keywords: Aged, Aging/metabolism, Bone Density, Bone and Bones/metabolism, Cognitive Dysfunction/epidemiology, Dementia/epidemiology, Humans, Osteoporosis/epidemiology, Risk Factors, Fracture, Epidemiology, Osteoporosis, Bone mineral density, Cognitive impairment, Dementia

Identifiers

Local EPrints ID: 497902
URI: http://eprints.soton.ac.uk/id/eprint/497902
ISSN: 1594-0667
PURE UUID: bcbf8a90-c4f3-4498-b66c-62e54cbf759b
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Fuggle: ORCID iD orcid.org/0000-0001-5463-2255
ORCID for Nicholas C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 04 Feb 2025 17:43
Last modified: 22 Aug 2025 02:25

Export record

Altmetrics

Contributors

Author: Elizabeth M. Curtis
Author: Mario Miguel
Author: Claire McEvoy
Author: Andrea Ticinesi
Author: Carla Torre
Author: Nasser Al-Daghri
Author: Majed Alokail
Author: Ewa Bałkowiec-Iskra
Author: Olivier Bruyère
Author: Nansa Burlet
Author: Etienne Cavalier
Author: Francesca Cerreta
Author: Patricia Clark
Author: Antonio Cherubini
Author: Cyrus Cooper ORCID iD
Author: Patrizia D'Amelio
Author: Nicholas Fuggle ORCID iD
Author: Celia Gregson
Author: Philippe Halbout
Author: John A. Kanis
Author: Jean Kaufman
Author: Andrea Laslop
Author: Stefania Maggi
Author: Andrea Maier
Author: Radmila Matijevic
Author: Eugene McCloskey
Author: Sif Ormarsdóttir
Author: Concha Prieto Yerro
Author: Régis P Radermecker
Author: Yves Rolland
Author: Andrea Singer
Author: Nicola Veronese
Author: René Rizzoli
Author: Jean-Yves Reginster

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×