Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. May 18, 2017; 8(5): 412-423
Published online May 18, 2017. doi: 10.5312/wjo.v8.i5.412
Dementia and osteoporosis in a geriatric population: Is there a common link?
Candice L Downey, Adam Young, Emily F Burton, Simon M Graham, Robert J Macfarlane, Eva-Maria Tsapakis, Eleftherios Tsiridis
Candice L Downey, Emily F Burton, University of Leeds, School of Medicine, Leeds LS2 9NL, United Kingdom
Adam Young, Department of Anaesthetics, Pinderfields Hospital, Wakefield WF1 4DG, United Kingdom
Simon M Graham, Robert J Macfarlane, Department of Trauma and Orthopaedics, the Royal Liverpool University Hospital, Liverpool L7 8XP, United Kingdom
Eva-Maria Tsapakis, Eleftherios Tsiridis, Academic Department of Orthopaedics and Trauma, Aristotle University Medical School, 54124 Thessalonika, Greece
Author contributions: Downey CL and Young A contributed equally to this work; Downey CL and Tsiridis EM designed the research; Downey CL, Young A and Burton EF performed the research and wrote the paper; Graham SM, Macfarlane RJ and Tsiridis EM provided significant contributions in drafting the paper and revising it critically for important intellectual content; Tsapakis EM provided expert review.
Conflict-of-interest statement: The authors confirm that there are no potential conflicts of interest. There is no financial support to declare.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Simon M Graham, MBChB, MRCS, Department of Trauma and Orthopaedics, the Royal Liverpool University Hospital, Prescot St, Liverpool L7 8XP, United Kingdom.
Telephone: +44-151-7062000 Fax: +44-151-7065806
Received: December 5, 2016
Peer-review started: December 6, 2016
First decision: January 16, 2017
Revised: February 8, 2017
Accepted: February 28, 2017
Article in press: March 2, 2017
Published online: May 18, 2017
Core Tip

Core tip: A potential pathological link between osteoporosis and dementia has been explored in observational studies, but there exists a lack of large scale randomised controlled trials. We hypothesise that dementia and osteoporosis have common yet independent aetiologies. The most compelling evidence lies in the APOE4 allele, a well-established risk factor for Alzheimer’s disease. APOE4 is associated with fracture, independent of dementia and falling. The mechanism behind this is postulated to be reduced plasma vitamin K levels in individuals exhibiting the APOE4 allele. This may be augmented by the nutritional deficiencies associated with dementia, known to include vitamins K and D.