Lower vertebral bone density linked to faster cognitive decline in study
A MESA analysis linked lower CT-measured spinal bone density with cognitive and selected brain changes, without proving it causes dementia.
By Priya Raghavan · Science Reporter
3 min read
Lower vertebral bone density and cognitive decline were linked in a study of older adults published in Radiology. The findings suggest chest CT scans already performed for other reasons could yield a bone-health signal associated with later brain changes, although the study does not establish a test for an individual’s dementia risk.
Johns Hopkins-led researchers conducted a secondary, longitudinal analysis of the Multi-Ethnic Study of Atherosclerosis, according to the Radiological Society of North America. The final group included 715 participants, with a median age of 69, who had non-contrast chest CT scans, brain MRI examinations and cognitive testing.
Does lower vertebral bone density cause dementia?
No. The research was observational, meaning it identified an association rather than proving that low bone density causes cognitive decline or dementia. Researchers said bone and brain changes could instead reflect shared aging-related factors, including insulin resistance, dyslipidemia and menopausal change, RSNA reported.
Earlier observational research has also reported a relationship between bone-health measures and cognitive impairment, but a 2025 systematic review said larger, more diverse longitudinal studies were needed to confirm the findings. That evidence does not establish which condition, if either, causes the other.
What did the study find?
Researchers used a deep-learning algorithm to calculate volumetric bone mineral density in thoracic vertebrae from existing chest CT scans. For every 0.1 g/cm3 lower baseline measurement, the global cognitive composite declined an additional 0.025 standard deviations per year, according to reporting on the study. Lower measurements were also associated with faster declines on the Cognitive Abilities Screening Instrument.
The analysis found associations with selected MRI measures. Lower vertebral bone mineral density was linked to faster accumulation of white-matter hyperintensities in the corpus callosum and a faster decline in fractional anisotropy, a measure of white-matter integrity, in the anterior limb of the internal capsule.
Results were not uniform across every measure. An apparent association with decline in total white-matter fractional anisotropy did not remain after a statistical correction for multiple comparisons, Medical Xpress reported. Medscape also reported that the associations were relatively modest and that residual confounding remained possible.
What role did diabetes play?
Diabetes modified the association between lower vertebral bone mineral density and progression of white-matter hyperintensities, the researchers found. That subgroup result needs replication and does not show that diabetes causes the bone-brain relationship.
The researchers said CT-derived spinal bone-density measures from scans obtained for purposes such as lung screening or calcium scoring might help identify people with parallel skeletal and neurologic changes. But CT-derived measurements would require validation across scanners, imaging protocols and clinical settings before they could be used routinely to predict cognitive decline, Medscape reported.
This story draws on original reporting from Medical Xpress.