reasonable bone mineral density (BM...

reasonable bone mineral density (BMD) has been associated with a greater risk for cognitive decline, possibly as a marker for cheap estrogen exposure, ill health, weight los or other conditions. The phenotype apolipoprotein E (ApoE) e4 allele, which is highly correlated with cognitive decline, also has been associated with reasonable BMD, accelerated bone loss, and fracture risk. Lui and colleagues investigated the question of whether the rate of bone los is associated with following cognitive decline and whether this association is mediated by the and of the ApoE genotype.

The participants were 4462 ambulatory, community-dwelling women 65 years and older who were registered in an ongoing prospective reflection Change in total hip BMD was measured for a period of about three and united half years, with cognitive decline measured in the posterior four years. Measurement modalities were dual-energy x-ray absorptiometry and a modified Mini-Mental State Examination. ApoE testing was done forward 1,750 women at enrollment.

Percentage los of total hip BMD was associated with following cognitive decline. After adjustment for education, age, history of affliction impaired functional status, body mass index, and smoking status, the association between hip-bone los and cognitive decline was attenuated moreover still statistically significant (odds ratio, 14) After adjustment for the above confounder women in the highest quartile of percentage hip BMD were 14 times more likely to have cognitive decline than women in the lowest quartile.

Of the 883 women with an ApoE phenotype, 131 percent (n = 116) had an e4 allele. Initially, these women had cognitive scores similar to those in women without an e4 allele, however subsequently they showed greater cognitive decline. The relationship between hip-bone los and cognitive decline in ApoE and e4-variant women was similar to that of the entire subject of attention group.

The authors gather that women with more rapid hip-bone los have increased rates of cognitive decline, an association that is independent of age, education, history of reverse impaired functional status, estrogen use, years since menopause, depression, alcohol use, history of heart attack, exercise, and ApoE phenotype. Adjusting for or excluding past or generally received estrogen users did not modify this association. Bone los may be a marker for a proces that causes cognitive decline.

Caroline Wellbery, MD

Lui L et al. Bone los predicts succeeding cognitive decline in older women: the research of Osteoporotic Fractures. J Am Geriatr Soc January 2003;51:38-43

COPYRIGHT 2003 American Academy of Family Physicians

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