Older women who were found to have extensive calcification of abdominal aorta on lateral spine images taken during dual-energy x-ray absorptiometry (DEXA) scans were at high risk of developing dementia later on in life, according to a study published in The Lancet Regional Health - Western Pacific. 

For this study, the researchers examined DEXA lateral thoracolumbar spine images of 958 women, aged (≥70 years, to evaluate the abdominal aortic calcification (AAC), which was then categorized as low, moderate and extensive. The DEXA scans were performed in 1998. Cardiovascular risk factors and apolipoprotein E (APOE) genotype were evaluated and adjusted for on multivariate analysis. The participants were followed up for development of new onset 14.5-year late-life dementia.

Around 45% women were found to have low AAC, 36.4% had moderate AAC, while nearly 20% had extensive calcification at study entry. Over follow-up of more than 14.5 years, 15.7% (n = 150) women either underwent late-life dementia-related hospitalization or they died.

The hospitalization rate due to dementia among women with moderate calcification was 15.5%, which increased to 18.3% among women with extensive calcification of the abdominal aorta, whereas the hospitalization rate in women with low AAC was less than 10%. Mortality was highest among women with extensive AAC (9.4%) compared to women with moderate (8.3%) and low calcification (2.8%).

On multivariate analysis, in contrast to women with low AAC, those with moderate and extensive calcification of abdominal aorta doubled their risk of future dementia late in life with adjusted hazard ratio of 2.03 and 2.10, respectively.

DEXA scan is a widely used test to estimate bone density. This study has demonstrated its utility as a non-invasive and cost-effective screening tool to identify the risk of cognitive decline followed by dementia among older women by additionally calculating the extent of calcification in the abdominal aorta at the same time as measuring bone density. Early detection allows timely institution of risk management to either prevent or delay the onset of dementia or check its progression.

Reference

1. Porter T, et al. Abdominal aortic calcification on lateral spine images captured during bone density testing and late-life dementia risk in older women: A prospective cohort study. Lancet Reg Health West Pac. 2022 June 26, DOI: https://doi.org/10.1016/j.lanwpc.2022.100502.