Title:Effects of Bisphosphonates and Calcium plus Vitamin-D Supplements on Cognitive Function in Postmenopausal Osteoporosis§
VOLUME: 16 ISSUE: 1
Author(s):Umut Safer, Vildan Binay Safer, Sibel Ozbudak Demir and Inci Yanikoglu
Affiliation:Istanbul Haydarpasa Numune Egitim Hastanesi Fiziksel Tıp ve Rehabilitasyon Servisi Uskudar, Istanbul, Turkey.
Keywords:Bisphosphonates, bone mineral density, cognitive reserve, mental state, osteoporosis.
Abstract:Background: Postmenopausal osteoporosis has been linked to accelerated cognitive decline;
however, little is known about the effects of medical treatment on cognitive functions.
Material and Methods: In this prospective study, we evaluated the effects of bisphosphonate treatment
and calcium plus vitamin D supplementation on cognitive functions in 45 women with postmenopausal
osteoporosis who were started on medical treatment. The medications included alendronate, zoledronic acid, risedronate,
or ibandronic acid along with a low or high dose of calcium plus vitamin D supplements. The cognitive function was
assessed by the mini-mental state examination (MMSE) test. All subjects underwent bone mineral density (BMD)
measurement via dual-energy X-ray absorptiometry at baseline and at study completion.
Results: The mean T-score improved significantly at 1 year, except for neck of the femur area. The mean MMSE score did
not change significantly at 12 months (26.40 ± 2.07 vs. 26.48 ± 2.07; p = 0.513), with no difference among
bisphosphonates combined with calcium plus vitamin D. Higher dose (1200 mg/800 U/day) of calcium plus vitamin D
supplementation tended to have a greater improvement as compared with lower dose (600 mg/400 U/day) (Δ MMSE:
0.11 ± 0.72 vs. −0.14 ± 0.69).
Conclusions: Cognitive functions in the women remained unaltered, whereas bone BMD T-scores were significantly
improved at the 12th month after the administration of bisphosphonates and calcium plus vitamin D supplements. Higher
doses of calcium plus vitamin D supplements were likely to have better cognitive effects as compared with lower doses.