Bisphosphonates and the risk of dementia in patients with osteoporosis or fragility fracture: A population-based study in Hong Kong

IF 13 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-07-21 DOI:10.1002/alz.70503

Chor-Wing Sing, Koon-Ho Chan, Patrick K. C. Chiu, Wallis C. Y. Lau, Xiaowen Zhang, Kathryn C. B. Tan, Ching-Lung Cheung

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引用次数: 0

Abstract

INTRODUCTION

Emerging evidence suggests neuroprotective effects of bisphosphonates. We aim to investigate whether nitrogen-containing bisphosphonates (NBPs) could reduce the risk of Alzheimer's disease and related dementia (ADRD).

METHODS

We identified patients aged 60+ with osteoporosis or fragility fracture in 2005–2020 from a healthcare database in Hong Kong. Patients receiving NBPs were 1:1 matched with untreated patients and those receiving other anti-osteoporosis medications (“non-NBPs”) by time-dependent propensity score. Follow-up was conducted until December 31, 2021. Cause-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazard model.

RESULTS

Among 121,492 patients (NBP = 15,654, non-NBP = 6331), we matched 10,833 pairs for NBPs-vs-untreated and 3080 pairs for NBPs-vs-non-NBPs. NBP use was associated with a lower risk of ADRD compared to untreated (HR = 0.84, 95% CI = 0.78–0.90) and non-NBP (HR = 0.76, 95% CI = 0.66–0.89).

DISCUSSION

NBP use was associated with a lower risk of dementia, suggesting further studies are warranted on its potential to improve cognitive function.

Highlights

Nitrogen-containing bisphosphonates (NBPs) are associated with a reduced risk of Alzheimer's disease and related dementia.
NBPs resulted in an absolute risk reduction of 0.007, 0.018, and 0.021 at 1, 3, and 5 years, respectively. The number needed to treat (NNT) with NBPs at 1, 3, and 5 years were 133, 56, and 48.
There is potential for repurposing NBPs as a therapeutic agent for Alzheimer's disease.

Abstract Image

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双膦酸盐与骨质疏松或脆性骨折患者痴呆风险：香港一项基于人群的研究

新出现的证据表明双膦酸盐具有神经保护作用。我们的目的是研究含氮双膦酸盐（nbp）是否可以降低阿尔茨海默病和相关痴呆（ADRD）的风险。方法：我们从香港的一个医疗数据库中确定了2005-2020年60岁以上的骨质疏松症或脆性骨折患者。根据时间依赖倾向评分，接受NBPs的患者与未接受治疗的患者和接受其他抗骨质疏松药物（“非NBPs”）的患者进行1:1匹配。随访持续至2021年12月31日。使用Cox比例风险模型估计原因特异性风险比（hr）和95%置信区间（ci）。结果在121492例患者中（NBP = 15654例，非NBP = 6331例），我们匹配了10833对NBP vs未治疗组，3080对NBP vs非NBP组。与未治疗（HR = 0.84, 95% CI = 0.78-0.90）和未使用NBP （HR = 0.76, 95% CI = 0.66-0.89）相比，使用NBP与较低的ADRD风险相关。nbp的使用与较低的痴呆风险相关，表明其改善认知功能的潜力有待进一步研究。含氮双膦酸盐（nbp）与降低阿尔茨海默病和相关痴呆的风险相关。NBPs在1年、3年和5年的绝对风险分别降低了0.007、0.018和0.021。在1年、3年和5年需要使用NBPs治疗（NNT）的人数分别为133、56和48。有可能将nbp重新用作阿尔茨海默病的治疗剂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.