Depression and bone loss as risk factors for cognitive decline: A systematic review and meta-analysis

Kanika Mehta; Sathya Priya Thandavan; Mohammadreza Mohebbi; Julie A Pasco; Lana J Williams; Ken Walder; Boon Lung Ng; Veer Bala Gupta

doi:10.1016/j.arr.2022.101575

Depression and bone loss as risk factors for cognitive decline: A systematic review and meta-analysis

Ageing Res Rev. 2022 Apr:76:101575. doi: 10.1016/j.arr.2022.101575. Epub 2022 Jan 28.

Authors

Kanika Mehta¹, Sathya Priya Thandavan¹, Mohammadreza Mohebbi², Julie A Pasco³, Lana J Williams¹, Ken Walder¹, Boon Lung Ng⁴, Veer Bala Gupta⁵

Affiliations

¹ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia.
² Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia; Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia.
³ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia; Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia; Barwon Health, Geelong, VIC, Australia.
⁴ Department of Geriatric Medicine, Barwon Health, Geelong, VIC, Australia.
⁵ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia. Electronic address: veer.gupta@deakin.edu.au.

PMID: 35093615
DOI: 10.1016/j.arr.2022.101575

Abstract

Background: Depression is linked to Alzheimer's disease (AD) but it is unclear whether depression is also associated with cognitive decline in the preclinical phase and mild cognitive impairment (MCI). Previous meta-analyses have only investigated AD as an outcome without accounting for individuals showing cognitive decline that does not meet the diagnostic criteria for AD. Other potentially modifiable risk factors such as bone loss have also been less explored and there remains uncertainty around their temporal relationship with cognitive decline.

Aims: To conduct a systematic review and meta-analysis investigating depression and bone loss as risk factors for subsequent cognitive decline.

Methods: A comprehensive search strategy was developed and applied using four databases; MEDLINE Complete, Embase, PsycINFO and CINAHL Complete. The pooled summary effects were estimated as odds ratios with 95% confidence intervals using a random-effects model. The study protocol was registered with PROSPERO (ID: CRD42020159369).

Results: A total of 75 longitudinal cohort studies were identified for meta-analysis, of which 70 examined the impact of depression on cognitive decline and five examined the impact of bone loss. Prior exposure to depression was found to be associated with cognitive score reduction (OR 1.33 95% CI 1.17, 1.51), MCI incidence (OR 1.52 95% CI 1.28, 1.79) and AD incidence (OR 1.79 95% CI 1.46, 2.2). Bone loss was also associated with the incidence of AD (OR=1.81 95% CI 1.28, 2.55).

Conclusions: Overall, the results support the hypothesis that depression is associated with subsequent cognitive decline. Bone loss was also found to be associated with AD incidence; however, due to the small number of studies, the results should be viewed with caution.

Keywords: Bone loss; Cognitive decline; Depression; Meta-analysis; Meta-regression; Risk.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Alzheimer Disease* / diagnosis
Cognitive Dysfunction* / diagnosis
Depression / epidemiology
Humans
Longitudinal Studies
Risk Factors