Patients taking common medications to treat osteoporosis showed a significantly lower risk of developing dementia in a large-scale study conducted by the University of Hong Kong. The research, published in the journal Alzheimer’s & Dementia, suggests that nitrogen-containing bisphosphonates (NBPs) may offer benefits beyond bone health.
The study analyzed electronic medical records of more than 120,000 patients aged 60 and older in Hong Kong. All participants had a diagnosis of osteoporosis or fragility fractures. The data covered a 15-year period from 2005 to 2020, allowing researchers to track the long-term effects of different treatments on cognitive health.
Significant Reduction in Dementia Cases
Researchers found that patients using NBPs, a class of drugs that includes alendronate and zoledronate, had a 16% lower risk of developing Alzheimer’s disease and related dementias compared to those who received no osteoporosis medication. The association was even stronger when comparing NBP users to patients taking other types of osteoporosis drugs. In that group, the risk of dementia was 24% lower.
Women and patients who had previously suffered hip fractures appeared to show the strongest link between NBP treatment and reduced dementia risk. The team estimated that treating 48 patients with these medications over five years could potentially prevent one case of dementia.
These drugs work by slowing the breakdown of bone tissue, which helps maintain bone strength and reduces the likelihood of fractures. Osteoporosis and dementia often affect the same older adults and share several risk factors, including advanced age, female gender, and low physical activity levels. Previous research by the same team established that osteoporosis and fractures are independent risk factors for dementia.
Existing Treatments for Future Protection
The findings highlight a potential dual benefit for widely available medications. Professor Cheung Ching-lung, who led the study, noted that these drugs already have an established history of use. He stated that the results provide an empirical basis for future research into the effectiveness of these medications in preventing or delaying cognitive decline.
“Our study provides evidence that NBPs may offer dual benefits in strengthening bones and reducing fracture risk, as well as potentially preventing ADRD,” Professor Cheung said. “Their potential neuroprotective role provides an empirical basis and supports future research on the actual effectiveness of this medication in preventing or delaying cognitive decline associated with ADRD.”
The World Health Organization has identified dementia as a major global health priority, with the number of people living with the condition projected to rise from 55 million to 139 million by 2050. While new medications to slow Alzheimer’s progression have recently gained approval, their high costs and limited suitability for some patients remain significant challenges.
Because this was an observational study, it does not prove that the drugs directly prevent dementia. However, the results support further investigation into whether these existing treatments can help delay cognitive decline in high-risk populations.
Dr Sing Chor-wing served as the first author of the study. Additional researchers from the Department of Medicine at HKUMed included Professor Chan Koon-ho, Dr Patrick Chiu Ka-chun, and Professor Kathryn Tan Choon-beng.
Source: ScienceDaily
