{
  "abstract": "Background\n\nBone fractures and Alzheimer's disease and other dementias (ADD) are major ageing-related conditions, but their population-level co-burden and ecological concordance remain incompletely characterized.Methods\n\nWe analyzed Global Burden of Disease estimates from 1990 to 2023 to characterize global, age-specific, country-level, and site-specific patterns of bone fractures and ADD. Pearson and Spearman ecological correlations and lagged analyses were performed across age groups, countries, and Socio-demographic Index strata. Separately, a hospital-based descriptive analysis of patients with recorded ADD diagnoses from 2015 to 2025 was conducted to provide clinical context and was not designed to validate the ecological findings.Results\n\nFracture and ADD incidence showed stronger ecological concordance in older age groups. The strongest unadjusted lagged ecological association was observed at approximately 3 years (r=0.930 (95% CI, 0.927-0.933; unadjusted P<2.2×10⁻¹⁶)). Hip, sternum/rib, and pelvic fractures showed positive site-specific correlations with lagged ADD incidence (r=0.62,0.59, and 0.58, respectively; all P<0.001). In the hospital-based cohort, 896 patients with recorded ADD diagnoses were included, of whom 342 (38.2%) had documented fracture records. Among these patients, fracture records preceded the first recorded ADD diagnosis in 195 cases (57.1%). Because no non-ADD comparison group was included, these findings were descriptive only.Conclusion\n\nFracture burden and ADD burden show age-dependent, site-specific, and lagged ecological concordance. In the hospital-based descriptive cohort, fracture records were frequently documented before the recorded dementia diagnosis date. These findings should be interpreted as hypothesis-generating and support future individual-level longitudinal studies to determine whether fragility fractures can serve as markers for subsequent cognitive decline.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Trauma Surgery, Emergency Surgery & Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Peidong Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Deng Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Jialiu Luo"
    },
    {
      "affs": [
        0
      ],
      "name": "Shunyao Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhiqiang Lin",
      "orcid": "0009-0000-7156-1081"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuaipeng Gu",
      "orcid": "0009-0005-7230-2328"
    },
    {
      "affs": [
        0
      ],
      "name": "Teding Chang"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhaohui Tang"
    },
    {
      "affs": [
        0
      ],
      "name": "Cong Zhang",
      "orcid": "0009-0002-2230-151X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6xy0p20k8pp1s.bib",
  "cited_by": 0,
  "doi": "10.2147/rmhp.s636188",
  "fulltext_url": "https://europepmc.org/articles/PMC13693523",
  "id": "6xy0p20k8pp1s",
  "issns": [
    "1179-1594"
  ],
  "landing_url": "https://europepmc.org/article/MED/42921516",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2738|Dementia and Cognitive Impairment Research"
    ]
  ],
  "openalex": "W7222915305",
  "pdf_url": "https://europepmc.org/articles/PMC13693523?pdf=render",
  "pmcid": "PMC13693523",
  "pmid": "42921516",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6xy0p20k8pp1s.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42921516",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921516"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Dementia and Cognitive Impairment Research",
      "subfield": "psychiatry"
    }
  ],
  "title": "Age- and Site-Specific Ecological Concordance Between Bone Fractures and Alzheimer's Disease and Other Dementias: A Global Burden Analysis with Hospital-Based Contextualization.",
  "title_text": "Age- and Site-Specific Ecological Concordance Between Bone Fractures and Alzheimer's Disease and Other Dementias: A Global Burden Analysis with Hospital-Based Contextualization.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/6xy0p20k8pp1s",
  "venue": "Risk management and healthcare policy",
  "versions": []
}