Lower CT-Derived Vertebral Bone Density Associated with Faster Brain Aging and Cognitive Decline

Lower thoracic bone mineral density on noncontrast chest CT was associated with faster cognitive decline (β -0.025 SD/year, P=.002) and regional white matter injury; diabetes amplified white matter hyperintensity progression.

• Lower BMD was associated with faster fractional anisotropy decline in the anterior limb of the internal capsule (β -0.048 SD/year; adjusted P=.006) and faster white matter hyperintensity accumulation in the corpus callosum (12.8%/year; adjusted P=.04).
• The association with total white matter FA decline was significant nominally (P=.02) but did not survive false discovery rate correction (adjusted P=.07).
• Diabetes amplified WMH progression (β=4.99%; P=.03).

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