Most of us know someone in the family who takes a small tablet for bones. It is a routine prescription after 60, often slipped into the morning pill box without a second thought. Now the same pill is getting a second look.
A large analysis of more than 120,000 older adults in Hong Kong has linked a common osteoporosis drug class to lower dementia risk. The study appeared in the journal Alzheimer's & Dementia.
Compared with patients taking other osteoporosis drugs, people on the medication had a 24% lower risk of dementia. Compared with patients on no bone drug at all, the risk was 16% lower.
The medications are called nitrogen-containing bisphosphonates, a class of pills that slow bone loss. The best-known is alendronate, sold as Fosamax, taken as a weekly tablet. The yearly infusion drug zoledronate, sold as Reclast, is in the same family.
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What the Hong Kong researchers actually measured
Researchers at the University of Hong Kong worked through electronic medical records for patients aged 60 and over who had osteoporosis or a fragility fracture between 2005 and 2020.
They matched users of the bisphosphonate class to similar patients who were not on the drug. The groups were then tracked for a median of about four years to see who developed Alzheimer's disease or another dementia.
To put a figure on the size of the effect, the authors calculated that treating 48 patients for five years might prevent one dementia case.
Why a bone drug might touch the brain
How a pill for bones would reach the brain is still an open question. The researchers point to early biology suggesting that the same cellular pathways these drugs act on may also play a role in how dementia develops.
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Lead researcher Professor Cheung Ching-lung framed the finding as a possible two-for-one effect. In the university's statement he said the drugs "may offer dual benefits in strengthening bones and reducing fracture risk, as well as potentially preventing ADRD".
ADRD is shorthand for Alzheimer's disease and related dementia.
What this does and does not mean for patients
The design is the big caveat. This is an observational study, not a randomized trial, so the group on the drug and the group without it may differ in ways the medical records did not capture.
Cognitive function at the start of the study was not measured. Known dementia risk factors like education, social isolation and hearing loss were also not in the database.
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Bisphosphonates are not approved to prevent dementia, and the authors are clear the finding is not a reason to prescribe one for that purpose. The next step they want is a randomized trial to see whether the drug actually lowers dementia rates.
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This article is made and published by Mie Hermansen, who may have used AI in the preparation.