失智症與骨質疏鬆症的相關性研究

目的：本研究旨在探討失智症與骨質疏鬆之間的關聯性，特別關注其盛行率、性別的調節角色，以及其他混雜變項的影響。方法：採橫斷面回溯性研究設計，分析台灣中部某醫學中心之資料庫。透過傾向分數配對（PSM）將1048位失智症患者與2096位無失智症者進行1:2配對，並以Mann–Whitney U檢定、卡方檢定及邏輯斯迴歸進行統計分析。結果：失智症組骨質疏鬆盛行率（60.0%）高於無失智症組（56.8%），惟差異未達顯著（p=0.087）。性別分層分析顯示，女性失智症患者的盛行率（68.7%）顯著高於無失智症女性（63.7%，p=0.022），而男性則無顯著差異。多變項邏輯斯迴歸顯示，年齡（OR=1.04, p=0.005）、骨折病史（OR=1.14, p=0.028）、退化性關節炎（OR=0.89, p=0.040）及糖尿病（OR=0.85, p=0.016）為獨立顯著預測因子；失智症在單變項分析中未達統計顯著（OR=1.06, p=0.267）。結論：失智症與骨質疏鬆的關聯性在控制混雜變項後未達統計顯著，顯示其可能受多重共病影響。年齡、骨折病史、退化性關節炎及糖尿病為骨質疏鬆的重要獨立預測因子，建議臨床及公共衛生策略應著重於這些風險因子的早期篩檢與介入，以降低骨質疏鬆與骨折風險。

Purpose: This study aimed to examine the association between dementia and osteoporosis, with a particular focus on prevalence, the moderating role of sex, and the influence of other confounding variables.Methods: A cross-sectional retrospective design was adopted, utilizing data from a medical center in central Taiwan. Propensity score matching (PSM) was performed to pair 1048 patients with dementia and 2096 without dementia at a 1:2 ratio. Statistical analyses included the Mann–Whitney U test, chi-square test, and logistic regression.Results: The prevalence of osteoporosis was higher in the dementia group (60.0%) than in the non-dementia group (56.8%), but the difference was not statistically significant (p=0.087). Sex-stratified analysis revealed that female patients with dementia had a significantly higher prevalence (68.7%) compared to non-dementia females (63.7%, p=0.022), whereas no significant difference was observed among males. Multivariable logistic regression identified age (OR=1.04, p=0.005), fracture history (OR=1.14, p=0.028), osteoarthritis (OR=0.89, p=0.040), and diabetes mellitus (OR=0.85, p=0.016) as independent predictors of osteoporosis. Dementia did not remain a significant predictor after adjustment for these variables (OR=1.06, p=0.267).Conclusions: The relationship between dementia and osteoporosis was not statistically significant after controlling for confounding factors, suggesting that it may be mediated by multiple comorbidities. Age, fracture history, osteoarthritis, and diabetes mellitus emerged as important independent predictors. Clinical and public health interventions should prioritize early screening and targeted prevention for individuals with these risk factors to reduce the burden of osteoporosis and related fractures.