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Abstract
Cognitive decline and dementia due to Alzheimer's disease (AD) have been associated with genetic, lifestyle, and environmental factors. A number of potentially modifiable risk factors should be taken into account when preventive or ameliorative interventions targeting dementia and its preclinical stages are investigated. Bone mineral density (BMD) and body composition are two such potentially modifiable risk factors, and their association with cognitive decline was investigated in this study. 164 participants, aged 34–87 years old (62.78 ± 9.27), were recruited for this longitudinal study and underwent cognitive and clinical examinations at baseline and after 3 years. Blood samples were collected for apolipoprotein E (APOE) genotyping and dual energy x-ray absorptiometry (DXA) was conducted at the same day as cognitive assessment. Using hierarchical regression analysis, we found that BMD and lean body mass, as measured using DXA were significant predictors of episodic memory. Age, gender, APOE status, and premorbid IQ were controlled for. Specifically, the List A learning from California Verbal Learning Test was significantly associated with BMD and lean mass both at baseline and at follow up assessment. Our findings indicate that there is a significant association between BMD and lean body mass and episodic verbal learning. While the involvement of modifiable lifestyle factors in human cognitive function has been examined in different studies, there is a need for further research to understand the potential underlying mechanisms.
Highlights
Dementia is a major debilitating disorder and a cause of significant concern for the currently aging population
Due to significant differences between men and women on dual energy x-ray absorptiometry (DXA) measures, we examined the interaction of gender and DXA measures (i.e., Siri underwater weight equivalents (UWE) Fat %, lean mass composite score, and Bone mineral density (BMD) composite score) in predicting cognitive functions
*p < 0.05; **p < 0.01; ***p < 0.001; aCambridge Contextual Reading Test; bUnderwater weight equivalents; c Lean mass composite score included the DXA Lean mass Z scores for Midriff, Pelvis, Left leg, Right leg, Left arm, and Right arm divided by six; d Bone Mineral Density Composite Score included the Z scores for DXA Spine. The results of this longitudinal study lend further support to the mounting body of evidence suggesting that lifestyle factors may be involved in cognitive functions and, in turn, may modulate the risk of future cognitive decline
Summary
Dementia is a major debilitating disorder and a cause of significant concern for the currently aging population. Prevalence projections indicate that dementia cases will dramatically increase worldwide by 2050 (Norton et al, 2014). A report from the Australian Institute of Health and Welfare estimates that the number of dementia patients in Australia will increase from 175,000 to 465,000 by the year 2031 (Australian Institute of Health and Welfare, 2007). Based on recent modeling reported by Alzheimer’s Australia, if the onset of dementia was delayed by 2 years, a reduction of 13% or 398,000 cumulative new cases by 2050 would be achieved. A delay of 5 years would reduce the number of cumulative new cases by 30%, or 935,000 individuals by 2050. Dementia-prevention programs would have a significant economic impact and improve the quality of life for affected individuals and their family (Vickland et al, 2012). Identification of potentially modifiable risk factors, including lifestyle factors, Frontiers in Aging Neuroscience www.frontiersin.org
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