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Osteoporosis Drugs Linked to Lower Alzheimer's Risk in Large Study
ReOsteoporosis Drugs Linked to Lower Alzheimer's Risk in Large Study
A study of more than 121,000 older adults in Hong Kong found that nitrogen-containing bisphosphonates, commonly used for osteoporosis, were associated with a 16% lower risk of Alzheimer's disease and related dementias. Researchers caution that the observational findings do not prove cause and effect and call for clinical trials.
Older adults who take a common class of osteoporosis drugs may be less likely to develop Alzheimer's disease and other forms of dementia, according to a large new study. The research, published in Alzheimer's & Dementia, found that use of nitrogen-containing bisphosphonates (NBPs) was associated with a 16% lower risk of Alzheimer's disease and related dementias compared with people who did not take osteoporosis medications.
The risk was 24% lower compared with those taking other types of osteoporosis drugs. The study followed 121,492 adults age 60 or older in Hong Kong, all of whom had recently been diagnosed with osteoporosis or had suffered a serious fracture of the spine, humerus, wrist or hip. None had previously taken medication for osteoporosis.
Nitrogen-containing bisphosphonates are medications that slow bone loss and reduce fracture risk. Common types include alendronate, ibandronate, risedronate and zoledronate. Osteoporosis, a condition in which bones become weaker and more prone to breaking due to loss of bone mass, is especially common among older adults, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
«Emerging evidence points to a bone-brain axis, suggesting a close link between bone and brain health,» said study author Ching-Lung Cheung, associate professor in the Department of Pharmacology and Pharmacy at the University of Hong Kong's Li Ka Shing Faculty of Medicine. «Our previous studies and those of others have found that people with low bone mass or osteoporosis are more likely to develop dementia later in life. This highlights the importance of maintaining good bone health, which may also help reduce the risk of dementia.»
However, the study was observational, meaning it cannot prove that bisphosphonates directly reduce dementia risk. «Our findings therefore do not prove that bisphosphonate use reduces dementia risk; this needs confirmation in a clinical trial,» Cheung said. He also noted that the study involved only a Chinese population, so it remains uncertain whether the results apply to other groups.
Other limitations include the lack of baseline cognitive testing, which means patients who already had cognitive impairment may have been less likely to receive osteoporosis treatment. Researchers also lacked information on the severity of participants' osteoporosis and fractures, as well as their use of over-the-counter calcium and vitamin D. External factors such as education level, social isolation, air pollution and vision loss could also have influenced dementia risk.
While the findings suggest that older patients receiving NBPs for osteoporosis or fragility fractures had lower rates of Alzheimer's and related dementias, they do not yet justify prescribing bisphosphonates specifically to prevent or treat the disease. The authors called for more research involving wider populations, with a focus on whether gender may play a role in the reduced risk.
«The next step is to confirm our observational findings in a clinical trial,» Cheung said. «If the benefit is demonstrated, it could have important implications for dementia management. We hope these findings encourage patients and healthcare professionals to weigh the overall benefits and risks and use appropriate treatment when indicated.»
