A large observational study of more than 120,000 older adults has found that a common class of osteoporosis drugs, nitrogen-containing bisphosphonates (NBPs), is associated with a lower risk of developing Alzheimer's disease and other dementias, researchers at the University of Hong Kong (HKUMed) reported.
The study, led by Professor Cheung Ching-lung of the Department of Pharmacology and Pharmacy at HKUMed's LKS Faculty of Medicine, analysed electronic medical records from across Hong Kong covering the period 2005 through 2020. All participants were aged 60 and older and had osteoporosis or fragility fractures.
The findings, published in the journal Alzheimer's & Dementia, showed that patients taking NBPs had a 16% lower risk of developing Alzheimer's disease and related dementias (ADRD) compared with patients who received no osteoporosis medication. When NBP users were compared with patients taking other types of osteoporosis drugs, the dementia risk was 24% lower among those receiving NBPs.
Women and patients who had experienced hip fractures appeared to show particularly strong associations between NBP treatment and reduced dementia risk. The researchers estimated that treating 48 patients with NBPs over five years could potentially prevent one case of dementia.
Osteoporosis and dementia often affect the same older adults and share several risk factors, including older age, being female and low levels of physical activity. Previous research by the same HKUMed team established that osteoporosis and fractures are independent risk factors for dementia.
The World Health Organization has identified dementia as a major global health priority. More than 55 million people worldwide currently live with dementia, a figure projected to climb to 139 million by 2050.
Professor Cheung said the findings suggest NBPs may offer dual benefits. "Our study provides evidence that NBPs may offer dual benefits in strengthening bones and reducing fracture risk, as well as potentially preventing ADRD," he 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."
Because the findings come from an observational study, they do not establish that the drugs themselves prevent dementia. Further studies will be needed to determine whether NBPs can directly prevent or delay Alzheimer's disease and related dementias.
Analysis
Why This Matters
- Dementia affects over 55 million people globally, with projections of 139 million by 2050, making affordable prevention strategies a global health priority
- NBPs are already widely available and have an established safety record, potentially offering a cost-effective approach to reducing dementia risk if causal links are confirmed
- The findings are particularly relevant for older adults who already need osteoporosis treatment, a population at elevated risk for both conditions
Background
Osteoporosis causes bones to become weaker and more vulnerable to fractures, while dementia progressively affects memory, thinking and the ability to carry out everyday activities. The two conditions share several risk factors, including older age, being female and low levels of physical activity. NBPs such as alendronate and zoledronate are among the most commonly prescribed osteoporosis treatments; they work by slowing the breakdown of bone tissue. Although the first medications designed to slow Alzheimer's progression have recently gained approval, their high costs and limited suitability for some patients have increased interest in identifying existing medications that might offer benefits beyond their original use.
Key Perspectives
Professor Cheung Ching-lung, HKUMed: said the findings suggest NBPs may offer dual benefits in strengthening bones and reducing fracture risk, as well as potentially preventing ADRD, and that the results support further research on the medication's actual effectiveness in preventing or delaying cognitive decline.
What to Watch
- Results from randomized controlled trials that could establish whether NBPs directly prevent or delay dementia
- Whether regulatory or clinical guidelines in other countries consider recommending NBPs for dementia prevention in high-risk older populations
- Ongoing research into the biological overlap between bone health and neurodegenerative processes
Checked
12 claims in this story checked against 1 source: 12 supported.
Show each claim
- SupportedCommon osteoporosis drugs are linked to lower dementia risk in a major study.Latest Science News -- ScienceDaily: “Common osteoporosis drugs linked to 24% lower dementia risk in major study.”
- SupportedHKU research links nitrogen-containing bisphosphonates to up to 24% lower Alzheimer’s and related-dementia risk than other osteoporosis drugs.Latest Science News -- ScienceDaily: “In that comparison, dementia risk was 24% lower among those receiving NBPs.”
- SupportedA study of more than 120,000 older adults found an association between nitrogen-containing bisphosphonates and lower Alzheimer’s and other dementia risk.Latest Science News -- ScienceDaily: “In a study involving more than 120,000 older adults, researchers at the University of Hong Kong (HKUMed) found that patients taking certain medications to strengthen their bones were significantly less likely to develop dementia.”
- SupportedThe study was led by Professor Cheung Ching-lung of HKUMed’s Department of Pharmacology and Pharmacy.Latest Science News -- ScienceDaily: “The research was led by Professor Cheung Ching-lung of the Department of Pharmacology and Pharmacy at HKUMed.”
- SupportedThe Hong Kong records covered 2005–2020 and included people aged 60 and older with osteoporosis or fragility fractures.Latest Science News -- ScienceDaily: “The records covered the period from 2005 through 2020, allowing the team to investigate how different osteoporosis treatments were associated with dementia risk over time.”
- SupportedCompared with people receiving no osteoporosis medication, NBP users had a 16% lower risk of Alzheimer’s disease and related dementias.Latest Science News -- ScienceDaily: “Patients taking NBPs had a 16% lower risk of developing Alzheimer's disease and related dementias compared with patients who received no osteoporosis medication.”
- SupportedCompared with people taking other osteoporosis drugs, NBP users had a 24% lower dementia risk.Latest Science News -- ScienceDaily: “In that comparison, dementia risk was 24% lower among those receiving NBPs.”
- SupportedWomen and patients who had experienced hip fractures appeared to show particularly strong associations between NBP treatment and reduced dementia risk.Latest Science News -- ScienceDaily: “Women and patients who had experienced hip fractures appeared to show particularly strong associations between NBP treatment and reduced dementia risk.”
- SupportedResearchers estimated that treating 48 patients with NBPs over five years could potentially prevent one dementia case.Latest Science News -- ScienceDaily: “The researchers also estimated that treating 48 patients with NBPs over five years could potentially prevent one case of dementia.”
- SupportedCheung said, “Our study provides evidence that NBPs may offer dual benefits in strengthening bones and reducing fracture risk, as well as potentially preventing ADRD.”Latest Science News -- ScienceDaily: “"Our study provides evidence that NBPs may offer dual benefits in strengthening bones and reducing fracture risk, as well as potentially preventing ADRD.”
- SupportedCheung 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.”Latest Science News -- ScienceDaily: “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."”
- SupportedThe observational findings do not establish that the drugs themselves prevent dementia.Latest Science News -- ScienceDaily: “Because the findings come from an observational study, they do not establish that the drugs themselves prevent dementia.”
