The Occurrence of Alzheimer's Disease and Parkinson's Disease in Individuals With Osteoporosis: A Longitudinal Follow-Up Study Using a National Health Screening Database in Korea

Mi Jung Kwon; Joo-Hee Kim; Ji Hee Kim; Seong Jin Cho; Eun Sook Nam; Hyo Geun Choi

doi:10.3389/fnagi.2021.786337

The Occurrence of Alzheimer's Disease and Parkinson's Disease in Individuals With Osteoporosis: A Longitudinal Follow-Up Study Using a National Health Screening Database in Korea

Front Aging Neurosci. 2021 Dec 8:13:786337. doi: 10.3389/fnagi.2021.786337. eCollection 2021.

Authors

Mi Jung Kwon¹, Joo-Hee Kim², Ji Hee Kim³, Seong Jin Cho⁴, Eun Sook Nam⁴, Hyo Geun Choi⁵

Affiliations

¹ Division of Neuropathology, Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
² Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
³ Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
⁴ Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.

Abstract

Background: Public health concerns regarding the potential link between osteoporosis and the increased occurrence of Alzheimer's disease (AD) and Parkinson's disease (PD) have been raised, but the results remain inconsistent and require further validation. Here, we investigated the long-term relationship of osteoporosis with the occurrence of AD/PD using data from a large-scale nationwide cohort. Methods: This longitudinal follow-up study included 78,994 patients with osteoporosis and 78,994 controls from the Korean National Health Insurance Service-Health Screening Cohort database (2002-2015) who were matched using propensity score matching at a 1:1 ratio based on age, sex, income, and residential area. A Cox proportional hazard model was used to assess the association between osteoporosis and the occurrence of AD/PD after adjusting for multiple covariates. Results: During the follow-up period, AD occurred in 5,856 patients with osteoporosis and 3,761 controls (incidence rates: 10.4 and 6.8 per 1,000 person-years, respectively), and PD occurred in 1,397 patients and 790 controls (incidence rates: 2.4 and 1.4 per 1,000 person-years, respectively). The incidences of AD and PD were significantly higher in the osteoporosis group than in the matched control group. After adjustment, the osteoporosis group exhibited 1.27-fold and 1.49-fold higher occurrences of AD (95% confidence interval (CI) = 1.22-1.32) and PD (95% CI = 1.36-1.63) than the controls, respectively. The results of subgroup analyses supported the increased occurrence of AD and PD in patients with osteoporosis, independent of income, residential area, obesity, smoking, alcohol consumption, hyperlipidemia, hypertension, or blood glucose level. Conclusion: Our results indicate that the presence of osteoporosis may increase the likelihood of developing two common neurodegenerative diseases in adults aged ≥40 years.

Keywords: Alzheimer’s disease; Parkinson’s disease; longitudinal follow-up study; nationwide population-based cohort study; osteoporosis.