Impact of smoking, diabetes, and exercise on dementia risk in women with osteoporosis: a nationwide cohort study

초록

The Summary Having osteoporosis significantly increases the risk of having dementia, particularly when combined with smoking and diabetes, but regular exercise can reduce this risk. Implementing a national health screening program is crucial for early detection of these modifiable risk factors and prevention of dementia in aging populations. Purpose To assess osteoporosis as a risk factor for dementia in the general population using nationwide dataset. Methods This study included 261,343 women aged 66 years who participated in the National Screening Program for Transitional Ages for Koreans and underwent their first medical checkup between January 2013 and December 2016. Participants were categorized into three groups based on bone mineral density (BMD): normal BMD, osteopenia, and osteoporosis. We investigated participants' demographic characteristics and chronic comorbidities that could affect dementia incidence. The hazard ratios (HRs) for dementia in individuals with osteoporosis and osteopenia were calculated and adjusted based on several risk factors. Results Despite adjusting for demographic characteristics and chronic comorbidities, the risk of dementia was 1.18-fold higher in the osteoporosis group than in the normal BMD group. Regarding Alzheimer's disease and vascular dementia, the risk was 1.18- and 1.25-fold higher in the osteoporosis group, respectively. Notably, participants with osteoporosis who smoked had a 1.82-fold higher HR than that of nonsmoking participants with normal BMD; participants with diabetes mellitus (DM) had a 1.92-fold higher HR than that of participants with normal BMD without DM. The HR for participants with osteoporosis who exercised regularly was 1.00, whereas it was 1.18 for those who did not exercise. Conclusion This population-based cohort study demonstrates that having osteoporosis significantly increases dementia risk, which is amplified by smoking and diabetes but reduced by regular exercise.

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