Lower bone density in the spine is linked to faster cognitive decline in adults, according to a Johns Hopkins University study published in Radiology.
Researchers discovered that participants with lower volumetric bone density in their thoracic vertebrae at the start of the trial experienced quicker deterioration in overall cognitive function over time.
Lead researcher Shadpour Demehri, a professor of radiology at Johns Hopkins University, emphasized that the findings do not show osteoporosis causes dementia. Instead, Demehri said the study observed a metabolic syndrome that may simultaneously trigger degeneration in both bone tissue and the brain.
Bone density measures the amount of minerals, such as calcium, contained within a specific volume of bone tissue. While low bone density weakens the skeleton and increases fracture risk, medical science has long had limited data regarding how bone mineral loss relates to brain function. The new research was published in Radiology, a peer-reviewed medical journal released by the Radiological Society of North America.
Brain scan findings and deep learning analysis
An interdisciplinary research team reanalyzed data gathered during the Multi-Ethnic Study of Atherosclerosis, known as MESA. The project evaluated participants who underwent non-contrast chest CT scans, brain magnetic resonance imaging scans, and formal cognitive testing.
To assess bone health, researchers utilized a deep learning algorithm developed at Johns Hopkins University to calculate volumetric bone density in the thoracic spine from baseline chest CT scans of 2,086 participants. The final analysis focused on 715 participants who had complete records spanning bone density measurements, brain MRIs, and cognitive evaluations.
Brain MRI scans were examined for white matter hyperintensities and reduced fractional anisotropy, which are two structural changes in brain microarchitecture known to accompany cognitive decline and elevated dementia risk. Lower volumetric bone density correlated directly with an accumulation of white matter hyperintensities in the corpus callosum, a region critical for executive function, working memory, and attention.
The study also linked lower bone density to a faster decline in overall white matter fractional anisotropy within the anterior limb of the internal capsule, another neural pathway involved in executive functioning. Fractional anisotropy measures the directionality of water diffusion along nerve tracts, providing an index of white matter integrity.
Shared metabolic risk factors and clinical screening
Demehri noted that the simultaneous decline of skeletal and neural health likely reflects common metabolic aging factors rather than a direct physical influence of bones on brain tissue. According to Demehri, underlying metabolic mechanisms such as insulin resistance, dyslipidemia, and hormonal changes during menopause could drive both conditions at the same time.
The researchers concluded that measuring volumetric bone density could help clinicians identify individuals at risk of dual skeletal and nervous system decline. Early identification would allow healthcare providers to initiate screening earlier and manage shared metabolic risk factors before severe degeneration occurs.
