Mental deterioration that occurs with aging may put women at
risk for increased bone loss, according to a report in the
October issue of the Journal of the American Geriatrics
Society. Compared with women whose bone mineral density
(BMD), a measure of bone strength, was in the normal range,
those with spine fractures had lower scores on standardized
tests of mental abilities and greater overall deterioration
in mental status.
The female hormone estrogen, which declines with age, may be
a major factor in this equation. Estrogen replacement
therapy (ERT) and blood levels of estrogens are associated
with bone density and some recen studies have suggested that
ERT may protect against mental decline and reduce the risk
of dementia. The researchers say the findings add further
support for the importance of maintaining adequate estrogen
status and bone strength as women age.
“Could estrogen prevent both bone loss and cognitive
function loss?”
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“Certainly this makes one wonder about the role of
estrogen,” says lead researcher Kristine Yaffe, MD.
Yaffe is an assistant clinical professor of psychiatry
at the University of California in San Francisco. “Could
estrogen prevent both bone loss and cognitive function
loss?” Cognitive function refers to complex thought
processes involved in learning and memory.
Approximately 10% of women over age 65 have cognitive
function loss, or loss of some aspects of mental
functioning, which puts them at risk for death and
disability as well as greater likelihood of
hospitalization and doctor visits. At least 30% of
women in this age group have low bone density. Together,
cognitive loss and low bone density are two of the
most common conditions affecting older women.
The study population consisted of 8,333 women age 65 or
older who were not taking estrogen replacement therapy
and were not demented. Bone density was measured at the
start of the study and again four to six years later.
Mental abilities were measured by three standardized
tests used to score various aspects of memory,
orientation, and visual-spacial skills.
Women with decreased bone strength had poorer scores on the
mental tests
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Women with the lowest levels of bone density were found to
be older and thinner and had more symptoms of depression.
In addition, these women were older when they had their
first menstrual cycle and younger when they went through
menopause, compared to women with higher bone density.
Also compared to women with higher levels of bone density,
women with decreased bone strength had poorer scores on
the mental tests. Women with spine fractures had the lowest
mental test scores and greatest odds of mental deterioration.
Woman with the lowest bone density levels were more likely
to have been diagnosed with dementia.
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Performance on the mental tests worsened over time. At the
four- to six-year follow-up, women with the greatest
decreases in bone density had the greatest reduction in
mental scores on all three tests. Compared with women with
higher bone density, those with the lowest bone density
levels were more likely to have been diagnosed with
dementia.
According to Yaffe and colleagues, it is unlikely that bone
density affects mental abilities directly, but poorer
thinking may diminish physical activity and in turn lead
to accelerated bone loss, or to weight loss that decreases
bone strength and increases the risk of bone fractures.
Although estrogen deficiency is one probable link in the
association between bone loss and loss of some mental
abilities, other possibilities include depression and
stroke, which have been shown to be associated with both
low bone density and mental decline. Still another
possibility, Yaffe says, is something called the
“terminal drop” hypothesis, which states that as people
age, multiple organ systems of the body fail
simultaneously. While the study only included women,
Yaffe says that the findings may be applicable to men as
well.
Source: WebMD
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