Executive functions and bone health: a focus on cognitive impulsivity and bone mineral density

Gabriella Martino, Alberto Sardella, Federica Bellone, Carmen Lasco, Viviana Langher, Valentina Cazzato, Assunta Penna, Carmelo Vicario, Nunziata Morabito, Antonino Catalano


Background: It is known that cognitive impairment is associated with low bone mineral density (BMD) and that low BMD is also observed in elderly people with neurodegenerative diseases, in which executive functions (EF) could be decreased. A limited number of studies investigated the association between EF with BMD and fracture risk in elderly women.

Aims: The aim of this study was to explore the association between cognitive impulsivity, BMD and fall risk in a sample of postmenopausal women evaluated for osteoporosis.

Methods: We consecutively recruited women who obtained a score ≥ 24 at the Mini Mental State Examination (MMSE). Cognitive impulsivity was evaluated by the Stroop Colour and Word Test (SCWT). BMD was detected by dual-energy X-ray absorptiometry at lumbar spine and femoral neck.

Results: Cognitive impulsivity, as evidenced by the greater number of errors at the SCWT, was significantly related with BMD values at lumbar spine and femoral neck (r= -0.39, p= 0.01 and r= -0.43, p= 0.008; respectively), suggesting a neuropsychological impairment in patients assessed for osteoporosis. Moreover, interference effect on response time was significantly associated with higher prevalence of falls (r= 0.342; p= 0.031).

Discussion and Conclusions: Our findings suggested a potential involvement of cognitive impulsivity on BMD and risk of fall. This is a relevant issue in clinical practice for both clinical psychologists and physicians who evaluate postmenopausal women, to eventually predict risk of fracture.


executive functions; clinical psychology; stroop test; falls; osteoporosis; bone mineral density.

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DOI: https://doi.org/10.6092/2282-1619/2019.7.2167


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