Age- and Site-Specific Ecological Concordance Between Bone Fractures and Alzheimer's Disease and Other Dementias: A Global Burden Analysis with Hospital-Based Contextualization.
- 1Department 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.
Abstract
Background
Bone 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
We 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
Fracture 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
Fracture 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.
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BibTeX
@article{zhang2026sitespecific,
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.}},
author = {Peidong Zhang and Deng Chen and Jialiu Luo and Shunyao Chen and Zhiqiang Lin and Shuaipeng Gu and Teding Chang and Zhaohui Tang and Cong Zhang},
journal = {Risk management and healthcare policy},
year = {2026},
month = oct,
doi = {10.2147/rmhp.s636188},
url = {https://europepmc.org/article/MED/42921516},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Age- and Site-Specific Ecological Concordance Between Bone Fractures and Alzheimer's Disease and Other Dementias: A Global Burden Analysis with Hospital-Based Contextualization.
AU - Peidong Zhang
AU - Deng Chen
AU - Jialiu Luo
AU - Shunyao Chen
AU - Zhiqiang Lin
AU - Shuaipeng Gu
AU - Teding Chang
AU - Zhaohui Tang
AU - Cong Zhang
PY - 2026
DA - 2026/10/19
JO - Risk management and healthcare policy
DO - 10.2147/rmhp.s636188
UR - https://europepmc.org/article/MED/42921516
AB - Background Bone 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 We 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 Fracture 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 Fracture 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.
SN - 1179-1594
ER -