Researchers in Hong Kong have reported that older adults who take nitrogen‑containing bisphosphonates (NBPs) for osteoporosis or fragility fractures experience a significantly lower risk of developing Alzheimer’s disease and other dementias. The observation comes from a large cohort of 121,492 individuals aged 60 or older.
Study Design and Findings
The participants were all newly diagnosed with osteoporosis or had suffered a recent serious fracture of the spine, humerus, wrist or hip. None of them had previously used any osteoporosis medication. Over the study period, those who were prescribed NBPs—medications such as alendronate, ibandronate, risedronate and zoledronate—showed a 16% reduced incidence of Alzheimer’s disease and related dementias compared with people who did not receive any osteoporosis treatment. When compared with patients taking other types of osteoporosis drugs, the risk reduction was even larger, at 24%.
The findings were published in the peer‑review journal Alzheimer’s & Dementia. Lead author Ching‑Lung Cheung, an associate professor in the Department of Pharmacology and Pharmacy at the University of Hong Kong’s Li Ka Shing Faculty of Medicine, highlighted the emerging concept of a “bone‑brain axis,” suggesting a physiological link between skeletal health and cognitive function.
Interpretation and Limitations
Cheung cautioned that the study’s observational design does not prove causation. “Our findings therefore do not prove that bisphosphonate use reduces dementia risk; this needs confirmation in a clinical trial,” he said. Several methodological constraints were acknowledged. Baseline cognitive testing was unavailable, meaning participants who already had cognitive impairment might have been less likely to receive osteoporosis treatment. Information on the severity of osteoporosis, the extent of bone fractures, and the use of over‑the‑counter calcium or vitamin D supplements was also missing.
External variables such as education level, social isolation, air pollution and vision loss could have influenced dementia risk but were not accounted for in the analysis. Moreover, the cohort consisted exclusively of a Chinese population, raising questions about the generalizability of the results to other ethnic groups.
Implications for Practice
Although the data suggest a protective association between NBPs and dementia, the authors emphasized that the findings do not yet justify prescribing bisphosphonates solely for dementia prevention or treatment. They called for further research, including randomized clinical trials and studies that explore potential gender differences in the observed risk reduction.
Cheung expressed optimism that, if confirmed, the association could have “important implications for dementia management.” He encouraged patients and healthcare professionals to consider the overall benefits and risks of osteoporosis treatment, especially when bone health is a concern, and to use appropriate therapy when indicated.
Mitchell Landsberg is a Senior Technology Correspondent at News Raise. He covers consumer electronics, artificial intelligence, software developments, and digital privacy trends.
