Osteoporosis Linked to Dementia Risk: Evidence from a Chinese Cohort Study
China: A large Chinese cohort study has reported that individuals with osteoporosis had an approximately 80% higher risk of developing dementia, while those with osteoporotic fractures showed more than a twofold increase in dementia risk. These findings suggest a strong link between bone health and cognitive decline in older adults.
The population-based study, published in Bone Research, was conducted by Jiangshui Wang from the Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine, Southern University of Science and Technology, Shenzhen, China, and colleagues. The researchers aimed to clarify the association between osteoporosis and subsequent dementia risk, an area where previous evidence has been inconsistent.
Using integrated healthcare data from Shenzhen, the investigators followed 176,150 community-dwelling adults aged 65 years or older who had no documented cognitive impairment at baseline. Participants were observed between 2018 and 2022. Diagnoses of osteoporosis, osteoporotic fractures, and dementia were identified through linked outpatient and inpatient medical records, along with death registration data, ensuring comprehensive follow-up.
The mean age of participants was 70.7 years, and 9,605 individuals had a prior diagnosis of osteoporosis. Over a median follow-up of 2.2 years, corresponding to more than 505,000 person-years of observation, the study documented 1,367 new cases of all-cause dementia. These included 617 cases of Alzheimer’s disease and 298 cases of vascular dementia.
The key findings were as follows:
- After adjustment for multiple confounders, physician-diagnosed osteoporosis was linked to a significantly higher risk of developing incident dementia.
- Older adults with osteoporosis had an approximately 80% increased risk of dementia compared with those without osteoporosis.
- The risk was more pronounced among individuals with a history of osteoporotic fractures, who showed more than a twofold increase in dementia risk.
- Participants with osteoporosis but no fracture history also had an elevated dementia risk, though lower than that of those with fractures.
- Similar associations were observed for both Alzheimer’s disease and vascular dementia, indicating a shared link between osteoporosis and different dementia subtypes.
- The authors suggested that chronic inflammation, hormonal imbalance, vascular dysfunction, and reduced mobility after fractures may contribute to the increased risk of cognitive decline.
The findings highlight important clinical and public health implications. Osteoporosis and dementia are both common age-related conditions that contribute substantially to disability and healthcare burden. According to the researchers, early detection and effective management of osteoporosis may offer benefits beyond fracture prevention and could play a role in reducing dementia risk.
In conclusion, the study provides robust evidence that osteoporosis, particularly when complicated by fractures, is associated with a higher likelihood of developing dementia.
The authors emphasized the need for early osteoporosis screening, fracture prevention strategies, and the incorporation of cognitive assessments into routine care for older adults. They also called for further research to explore underlying mechanisms and to determine whether improving bone health can help mitigate long-term cognitive decline.
Reference:
Wang, J., Wang, S., Jin, C., Li, X., Mo, C., Zheng, J., Lu, X., Liang, F., & Gu, D. (2025). Osteoporosis and risk of dementia among older adults: A population‑based cohort study. Bone Research, 13(1), 104. https://doi.org/10.1038/s41413-025-00480-7
Next Story