Association Between Cognitive Functions and Bone Health in the Elderly: The NHANES, 2013-2014

We examined the association of cognitive function with bone mineral density (BMD), osteoporosis, and osteopenia. We identified 1070 participants (528 men) aged ≥60 years or older from the NHANES, 2013-2014. BMD was measured using dual-energy X-ray absorptiometry (DXA). Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning sub-test, Animal Fluency test, and Digit Symbol Substitution Test (DSST). After adjusting for covariates, one standard deviation increase in the DSST score was associated with increased BMD of the total hip (β = 0.022, P = 0.007), femoral neck (β = 0.024 P = 0.004), and lumbar spine (β = 0.025, P = 0.005) in females. When comparing females in the highest quartile of the DSST score to those in the lowest quartile, the highest score group was associated with a lower risk of osteoporosis [odds ratio (OR), 0.25; 95 % CI, 0.09-0.70] and osteopenia [OR, 0.35 (0.16-0.76)]. No associations were found between the CERAD test, Animal Fluency test, and bone health in females, or between cognitive function and bone health in males. In conclusion, higher DSST scores were associated with higher BMD and lower risk of osteoporosis and osteopenia in elderly females.