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| 1 | Dementia and osteoporosis in a geriatric population: Is there a common link?显示文摘AIM To determine the existence of a common pathological link between dementia and osteoporosis through reviewing the current evidence base. METHODS This paper reviews the current literature on osteoporosis and dementia in order to ascertain evidence of a common predisposing aetiology. A literature search of Ovid MEDLINE(1950 to June 2016) was conducted. The keywords 'osteoporosis', 'osteoporotic fracture', 'dementia' and 'Alzheimer's disease'(AD) were used to determine the theoretical links with the most significant evidence base behind them. The key links were found to be vitamins D and K, calcium, thyroid disease, statins, alcohol and sex steroids. These subjects were then searched in combination with the previous terms and the resulting papers manually examined. Theoretical, in vitro and in vivo research were all used to inform this review which focuses on the most well developed theoretical common causes for dementia(predominantly Alzheimer's type) and osteoporosis.RESULTS Dementia and osteoporosis are multifaceted disease processes with similar epidemiology and a marked increase in prevalence in elderly populations. The existence of a common link between the two has been suggested despite a lack of clear pathological overlap in our current understanding. Research to date has tended to be fragmented and relatively weak in nature with multiple confounding factors reflecting the difficulties of in vivo experimentation in the population of interest. Despite exploration of various possible mechanisms in search for a link between the two pathologies, this paper found that it is possible that these associations are coincidental due to the nature of the evidence available. One finding in this review is that prior investigation into common aetiologies has found raised amyloid beta peptide levels in osteoporotic bone tissue, with a hypothesis that amyloid beta disorders are systemic disorders resulting in differing tissue manifestations. However, our findings were that the most compelling evidence of a common yet independent aetiology lies in the APOE4 allele, which is a well-established risk for AD but also carries an independent association with fracture risk. The mechanism behind this is thought to be the reduced plasma vitamin K levels in individuals exhibiting the APOE4 allele which may be amplified by the nutritional deficiencies associated with dementia, which are known to include vitamins K and D. The vitamin theory postulates that malnutrition and reduced exposure to sunlight in patients with AD leads to vitamin deficiencies. CONCLUSION Robust evidence remains to be produced regarding potential links and regarding the exact aetiology of these diseases and remains relevant given the burden of dementia and osteoporosis in our ageing population. Future research into amyloid beta, APOE4 and vitamins K and D as the most promising aetiological links should be welcomed. | Candice L Downey Adam Young Emily F Burton Simon M Graham Robert J Macfarlane Eva-Maria Tsapakis Eleftherios Tsiridis | 2017 | World Journal of Orthopedics2017，8，5： | 6 |
| 2 | 1998Outcome of low back pain in general practice:a prospective study显示文摘 | Croft P R Macfarlane G L Papageorgiou A Cetal | 1998 | BMJ1998，316，： | 1 |
| 3 | A three-color,solid-state,three-dimensional display显示文摘 | Downing E Hesselink L Ralston J Macfarlane R | 1996 | Science1996，273，5279： | 1 |
| 4 | The mitochondrial genomes of two nematodes, Caenor- habditis elegans and Ascaris suum显示文摘 | Okimoto R Macfarlane J L Clary D O | 1992 | Genetics1992，130，： | 1 |
| 5 | Interleukin-18, the metabolic syndrome, and subclinical atherosclerosis:results from the Dallas Heart Study 显示文摘 | Zirlik A AbduUah SM Gerdes N MacFarlane L Schonbeck U Khera A | 2007 | Arterioscler Thromb Vasc Biol2007，27，： | 1 |
| 6 | Clinical utility of monitoring tacrolimus blood concentrations in liver transplant patients 显示文摘 | Venkataramanan R Shaw L M Sarkozi L Mullins R Pirsch J MacFarlane G | 2001 | J Clin Pharmacol2001，41，： | 1 |
| 7 | Quantitative and qualitative studies of gut flora in striped bass from estuarine and coastal marine environments 显示文摘 | MacFarlane R D McLaughlin J J Bullock G L | 1986 | Wildl Dis1986，22，3： | 1 |
| 8 | MicroRNA : Biogenesis, function and role in cancer 显示文摘 | Macfarlane L A Murphy P R | 2010 | Curr Genomics2010，11，7： | 1 |
| 9 | Executive dysfunction correlates with candate nucleus atrophy in patients with white matter changes on MRI: A subset of LADIS显示文摘 | Macfarlane M D Looi J C L Waheriang M | 2013 | Psychiatry Res2013，214，1： | 1 |
| 10 | Sugars exert a major influence and have low toxicity to embryos and oocytos显示文摘 | Kuleshova L L MacFarlane D R Trounson A Q | 1999 | Cryobiology1999，38，2： | 1 |
| 11 | Analytical validation of the PRO-Trac Ⅱ ELISA for the determination of tacrolimus (FK506) in whole blood 显示文摘 | MACFARLANE G D SCHELLER D G ERSFELD D L | 1999 | Clin Chem1999，45，9： | 1 |
| 12 | Maximizing thoracic organ transplant opportunities: the importance of efficient coordination显示文摘 | Snell GI Griffiths A Macfarlane L | 2000 | J Heart Lung Transplant2000，19，4： | 1 |
| 13 | Sources of lead in the San Cristobal Pulacayo and Potosimining districts Bolivia and revaluation of regional ore lead iso- tope provinces 显示文摘 | Kamenov G Macfarlane A W Riciputi L | 2002 | Economic Geology2002，97，3： | 1 |
| 14 | The associated reaction rating scale: a clinical tool to measure associated reactions in the hemiplegie upper limb 显示文摘 | Macfarlane A Turner-Stokes L DeS-uza L | 2002 | Clin Rehabil2002，16，7： | 1 |
| 15 | Nucleotide correlations that suggest tertiary interactions in the TV- replacement loop-containing mitochondrial tRNAs of the nematodes, Caenorhabditis elegans and Ascaris sum显示文摘 | Wolstenholme D R Okimoto R Macfarlane J L | 1994 | Nucleic Acids Res1994，22，20： | 1 |
| 16 | Training of disaster managers at a masters degree level: from emergency care to managerial control 显示文摘 | Macfarlane C Joffe A L NaidooS | 2006 | Emerg Med Australas2006，18，56： | 1 |
| 17 | A three-color,solid-state,three-dimensional display显示文摘 | Downing E Hesselink L Ralston J Macfarlane R | 1996 | Science1996，273，： | 1 |
| 18 | Sources of lead in the San Cristobal, Pulacayo, and Potosi mining districts, Bolivia, and a reevaluation of regional ore lead isotope provinces 显示文摘 | Kamenov G Macfarlane A W Riciputi L | 2002 | Econ Geol2002，97，3： | 1 |
| 19 | Homogeneous Broadening and Hyperfine Structure of Optical Transitions in Pr^3+: Y2SiO5 显示文摘 | Equall R W Cone R L Macfarlane R M | 1995 | Phys Rev B1995，52，6： | 1 |
| 20 | Black carbon in marine particulate organic carbon :Inputs and cycling of highly recalcitrant organic carbon in the Gulf of Maine 显示文摘 | GERVANTES D X F PLATA D L MACFARLANE J K | 2009 | Marine Chemistry2009，113，34： | 1 |
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