Women with Alzheimer's disease and osteoporosis are at increased risk for fracture of the hip and vertebra. Many women with Alzheimer's disease are prone to falls, and a fracture can significantly decrease the quality of life, and may increase morbidity.
Studies have shown that women with Alzheimer's are deficient in vitamin D, which affects bone mineral metabolism. The mechanism of action is not fully understood, whether the osteoporosis or hypovitamin d state comes first. But it is widely known that women with Alzheimer's have an increased risk for developing osteoporosis.
A recent study published in August 2005 measured the effects of calcium and vitamin D supplementation with or without risedronate. Risedronate is a commonly prescribed pharmaceutical for treating osteoporosis.
A total of 500 elderly women with Alzheimer are enrolled in the study. They were randomized to two groups. The treatment group received 2.5mg of risedronate with 1000 IU of Vitamin D and 1200mg of calcium while the control group received Vitamin D and calcium alone. Average follow-up was 18 months. Primary outcome measures were incidence of fracture (non-vertebral) and vertebral. Serum levels of vitamin D and parathyroid hormone were also measured at baseline and completion of the study. Bone mineral density was also measured for all participants' pre and post treatment.
They found that at baseline both groups had lower than normal levels of Vitamin D and higher levels of parathyroid hormone. Bone mineral density increased in the treatment group over the 18 month period by 4.1%, and decreased in the control group by 0.9% despite a correction of the vitamin D deficiency in both groups. Only 8 patients in the treatment group had a fracture (5 non-vertebral), while 29 in the control group suffered a fracture (24 non-vertebral).
The authors concluded that women with Alzheimer's disease are at increased risk for fracture due to deficiency in Vitamin D. However, correction of the deficiency with Vitamin D and calcium alone does not improve bone mineral density. The addition of risedronate to the treatment protocol significantly improves bone mineral density and decrease the risk of fracture.
Posted by Kristopher Foster on March 28, 2006 01:40 PM
