ASSOCIATION BETWEEN COGNITIVE IMPULSIVITY AND BONE MINERAL DENSITY: A CROSS-SECTIONAL STUDY IN POSTMENOPAUSAL WOMEN EVALUATED FOR OSTEOPOROSIS

Objectives: The potential involvement of executive functions impairment on BMD is still unclear. The aim of this study was to investigate the correlations between cognitive impulsivity, BMD and fall risk. Methods: Cognitive impulsivity was measured by Stroop Color and Word Test (SCWT) administration in a setting of 40 consecutively recruited postmenopausal women referring to a outpatients clinic for the evaluation of fracture risk. SCWT is a neuropsychological test able to assess the ability to inhibit cognitive interference: during the administration, women were required to quickly read three different tables of which two represented the “congruous condition” in which participants were invited to read names of colors printed in black ink and name different color patches. In the third table, named “incongruous condition”, color-words were printed in inconsistent color ink (e.g. the word “red” is printed in green ink) and participants were required to name the color of the ink instead of reading the word. Women with Mini Mental State Examination (MMSE) score <24, known neurologic or psychiatric disorders, history of significant hearing or visual impairment, or significant physical disability, history of uncontrolled diabetes and abnormal thyroid function, cancer, heart, respiratory, kidney or liver failure were excluded. BMD was measured at lumbar spine and femoral site by a DXA densitometer (Hologic Discovery). History of falls in the previous 12 months was recorded Results: Cognitive impulsivity, as highlighted by making errors at the SCWT, was significantly associated with lumbar spine and femoral neck T-score (r=-0.39, p=0.01 and r=-0.43, p=0.008; respectively). MMSE score was not associated with T-score values, neither at lumbar spine (r=0.09, p=0.5) nor at femoral neck (r=0.2, p=0.21); differently MMSE score was significantly associated both with Stroop test error (r=-0.34, p=0.02) and time interferences (r=-0.39, p=0.01). Furthermore, time interference was positively associated with the self-reported history of falls (r=0.342; p=0.031). Conclusions: Cognitive impulsivity was significantly associated with BMD values and higher prevalence of falls in postmenopausal women. It could be considered as a possible clinical risk factor for osteoporotic fractures.