Lower bone density in the spine is linked with poorer cognitive function, in research findings that could be of particular importance for postmenopausal women.
The study, in Radiology, suggests that chest computed tomography (CT) scans could help identify people with accelerated brain aging who might be at risk of dementia.
The deep-learning analysis found that bone density in the thoracic vertebrae of the spine was associated with both functional and imaging measures of age-related brain degeneration at a later stage.
Nonetheless, the researchers caution that their results do not mean osteoporosis causes dementia.
“This study is not about cause and effect, but rather the observation of a metabolic syndrome that may cause both bone and brain degeneration,” said researcher Shadpour Demehri, MD, from Johns Hopkins university in Baltimore, Maryland.
“The co-occurrence observed in the study may reflect shared metabolic drivers of aging, including insulin resistance, dyslipidemia, and menopausal change, rather than a direct bone-to-brain effect.”
The study is the first longitudinal secondary analysis linking baseline vertebral bone mineral density to changes in white matter structure, white matter hyperintensity progression, and cognition.
It included 715 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent noncontrast chest CT scans together with MRI and cognitive besting.
Longitudinal data on white matter hyperintensities and fractional anisotropy were available for 408 and 405 of these individuals, respectively.
Imaging and clinical assessments revealed that lower baseline thoracic vertebral volumetric bone mineral density (vBMD) was associated with white matter injury and faster decline in global cognition, particularly among people with diabetes.
Lower baseline vBMD was associated with a faster decline in global cognitive performance, with this link seen in specific brain regions.
Specifically, lower vBMD was associated with faster accumulation of white matter hyperintensities in the corpus callosum, which is associated with executive functioning, working memory, and attention.
It also correlated with faster fractional anisotropy decline in the anterior limb of the internal capsule, which is involved in executive function as well.
“Identifying individuals, particularly postmenopausal women, with low vBMD may help flag those at risk for parallel skeletal and neurologic decline, allowing earlier screening and shared risk-factor management,” reported lead researcher Sara Momtazmanesh, MD, also from Johns Hopkins, and co-workers.
They summarized: “These findings support the potential value of deep learning–enabled opportunistic vBMD assessment on chest CT for risk stratification beyond skeletal outcomes.”
