Abstract

Background Cognitive impairment is known to be associated with low bone mineral density (BMD) and low levels of BMD have been associated with increased rates of progression from mild cognitive impairment to Alzheimer’s disease and with the onset of episodic verbal learning deficit. Objectives The potential involvement of executive functions impairment on BMD is still unclear. The aim of this study was to investigate the correlations between cognitive impulsivity, BMD and fall risk. Methods Cognitive impulsivity was measured by Stroop Color and Word Test (SCWT) administration in a setting of 40 consecutively recruited postmenopausal women referring to a outpatients clinic for the evaluation of fracture risk. SCWT is a neuropsychological test able to assess the ability to inhibit cognitive interference: during the administration, women were required to quickly read three different tables of which two represented the “congruous condition” in which participants were invited to read names of colors printed in black ink and name different color patches. In the third table, named “incongruous condition”, color-words were printed in inconsistent color ink (e.g. the word “red” is printed in green ink) and participants were required to name the color of the ink instead of reading the word. Women with Mini Mental State Examination (MMSE) score Results Cognitive impulsivity, as highlighted by making errors at the SCWT, was significantly associated with lumbar spine and femoral neck T-score (r= -0.39, p= 0.01 and r= -0.43, p= 0.008; respectively). MMSE score was not associated with T-score values, neither at lumbar spine (r= 0.09, p= 0.5) nor at femoral neck (r= 0.2, p= 0.21); differently MMSE score was significantly associated both with Stroop test error (r= -0.34, p= 0.02) and time interferences (r= -0.39, p= 0.01). Furthermore, time interference was positively associated with the self-reported history of falls (r= 0.342; p= 0.031). Conclusion Cognitive impulsivity was significantly associated with BMD values and higher prevalence of falls in postmenopausal women. It could be considered as a possible clinical risk factor for osteoporotic fractures.

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