Quick answer: A September 2026 study in Radiology found that older adults with lower spinal bone density had faster cognitive decline and more white matter changes in the brain. The study shows an association, not cause and effect, and it does not mean osteoporosis causes dementia. The findings point to shared whole-body factors, such as metabolic health, that may affect bone and brain together.
What if the health of your bones could tell us something important about the health of your brain? For decades, I’ve encouraged women to think of osteoporosis as more than simply a problem of thinning bones. Our skeleton is a living, metabolically active organ system, constantly responding to our nutrition, hormones, movement, stress levels, and overall health. Now, fascinating new research published in September 2026 in the journal Radiology adds another piece to this picture.
Researchers found that older adults with lower spinal bone density experienced faster cognitive decline and greater changes in certain areas of the brain’s white matter over time. Does this mean osteoporosis causes dementia? Absolutely not. The researchers themselves caution against drawing that conclusion. But what this study does suggest is something I have emphasized throughout my more than 40 years of bone health research: Our bones do not exist in isolation from the rest of our body.
And when we support the health of the whole person, we create a better foundation for healthy aging.
The Surprising Connection Between Bone Density and Brain Aging
The study, led by researchers at Johns Hopkins University, examined information from the Multi-Ethnic Study of Atherosclerosis (MESA), a long-running research project investigating cardiovascular and metabolic health. The researchers focused on 715 older adults, with a median age of 69, who had undergone chest CT scans, brain MRI examinations, and cognitive testing. Here’s what makes this research especially interesting.
Rather than requiring new bone density scans, scientists used artificial intelligence to measure the density of the thoracic vertebraeâthe bones in the middle portion of the spineâfrom chest CT images already collected for other medical purposes. They then examined whether those bone measurements were associated with changes in memory, thinking ability, and the brain’s white matter over time.
What did the researchers discover?
Participants with lower vertebral bone density showed several concerning patterns:
- Faster cognitive decline: Overall cognitive performance declined more rapidly in those with lower spinal bone density.
- Changes in brain white matter: Certain brain pathways involved in communication between different regions showed greater deterioration.
- More white matter abnormalities: Researchers observed faster accumulation of abnormalities in the corpus callosum, a structure that connects the brain’s two hemispheres.
- Changes in areas associated with executive function: These include brain networks involved in planning, attention, and organizing information.
These associations were statistically significant in specific analyses, although the measured effects were generally modest. One important detail: not every measure of white matter health showed a statistically robust association after researchers adjusted for multiple comparisons. This is important because we want to understand what the science actually tells us, rather than turning an interesting finding into an unnecessarily frightening headline.
Dr. Brown’s Perspective: Your Bones May Reflect Your Whole-Body Health
When I read studies like this, I am reminded of a fundamental principle of the Better Bones approach. Bone loss is often a signal that something in the body’s overall health and metabolic balance deserves attention. We tend to think of osteoporosis as an isolated skeletal condition. A woman receives her bone density results, sees a low T-score, and is understandably concerned about fractures.
But I encourage women to ask a bigger question:
Why might my bones be losing strength in the first place?
Is there a nutritional deficiency? Chronic inflammation? Poor digestion or nutrient absorption? Hormonal changes? Insufficient muscle activity? An underlying medical condition? These questions matter because many of the biological systems influencing bone health also influence the health of other tissues and organs. This new research suggests that the brain may be part of that larger picture.
Could bone loss and brain aging share the same underlying causes?
The researchers propose that lower bone density and cognitive decline may reflect common metabolic processes.
Among the possibilities they discuss are:
1. Insulin resistance and metabolic dysfunction
Our ability to regulate blood sugar and use energy efficiently affects many tissues throughout the body. Insulin resistance has been associated with changes in both skeletal metabolism and brain health.
2. Hormonal changes during aging
Estrogen plays an important role in maintaining bone density, particularly during and after menopause. Hormonal changes may also influence vascular and neurological health, although the relationships are complex.
3. Changes in blood lipids and vascular health
Healthy circulation is essential for delivering oxygen and nutrients throughout the body, including to the brain. Metabolic and vascular changes may contribute to several aspects of aging simultaneously. What I find particularly compelling is that this research encourages us to look beyond individual diagnoses and consider the body’s interconnected systems. I explored a related idea in What’s good for the bones is good for brain health.
However, these are proposed explanationsânot mechanisms proven by this particular study.
Does Having Osteopenia or Osteoporosis Mean You Will Develop Dementia?
No. And I want to be very clear about that. If you have received an osteopenia or osteoporosis diagnosis, this study is not a reason to assume you are destined to experience cognitive decline. The research identified an association between lower bone density and certain changes in cognitive and brain imaging measurements. It did not establish that one condition causes the other. It also did not show that everyone with low bone density experienced meaningful cognitive problems.
The researchers studied an observational population, not an intervention in which people were treated to improve their bone density. Therefore, we cannot conclude that raising bone density will prevent dementia or reverse changes in the brain. And there is another important distinction: the study measured volumetric bone density in the thoracic spine using CT imaging. That is not the same measurement as the hip and lumbar spine T-scores commonly reported on a DEXA scan.
We should not assume that a particular DEXA T-score predicts an individual’s cognitive future. I often remind women that a bone density diagnosis is information, not destiny. The same principle applies here.
Five Ways to Support Your Bones and Overall Healthy Aging
Although this study did not test specific treatments or lifestyle interventions, it provides a useful opportunity to discuss the foundations of healthy aging. These are the principles I have emphasized throughout my career, and they remain central to my Better Bones, Better Body approach.
1. Nourish your body with an alkaline-forming, nutrient-rich diet
Food provides the raw materials our bodies need for maintaining bone, muscle, and countless other tissues.
My recommendation is a pH-balanced, largely alkaline-forming diet emphasizing:
- Abundant colorful vegetables and fruits
- Mineral-rich leafy greens
- Nuts and seeds
- Beans and other nutrient-dense plant foods
- Adequate high-quality, clean protein
- A wide variety of whole, minimally processed foods
Vegetables and fruits provide potassium, magnesium, antioxidants, and other compounds that support normal cellular function. Protein is also essential. Our bones contain a substantial protein matrix, and maintaining muscle mass becomes increasingly important with age. I encourage women to pay attention to their overall mineral intake and dietary balance. In my nutritional approach, I also use first-morning urine pH testing as a way to observe dietary acidâalkaline patterns over time.
It is important to understand that urine pH does not measure blood pH, diagnose mineral deficiencies, or directly establish bone strength. Blood pH is tightly regulated by the body. A nourishing diet can support overall health, but we cannot claim from this study that alkaline-forming foods prevent cognitive decline.
2. Build muscle to help build stronger bones
One of the most important concepts in bone health is the close relationship between muscle and bone. Muscles and bones function together as a unit. When muscles contract and place appropriate mechanical loads on our skeleton, they provide signals that help maintain bone strength. That’s why I encourage women to incorporate safe, progressive exercise into their lives. Depending on individual ability and fracture risk, this might include walking, resistance training, balance exercises, posture work, and appropriate weight-bearing activities.
Physical activity also has well-established benefits for cardiovascular health, physical function, and several aspects of cognitive well-being. I particularly like approaches that strengthen muscles while improving balance and confidence. Our Better Bones Weighted Exercise Vest is one tool designed to add adjustable resistance to appropriate activities (see also our weighted vest osteoporosis study coverage). However, anyone with osteoporosis, spinal fractures, balance difficulties, or other medical concerns should work with a qualified healthcare professional to determine whether weighted exercise is suitable.
Remember: it is never too late to begin improving your physical function.
3. Pay attention to your metabolic health
If there is one broader lesson from this new research, it is that metabolic health deserves our attention. Blood sugar regulation, lipid levels, blood pressure, and cardiovascular health are all important parts of healthy aging. I encourage women to work with their healthcare providers to understand their individual risk factors rather than focusing exclusively on bone density. A comprehensive evaluation may identify conditions that affect bone health and require specific treatment.
4. Make sure you are getting the nutrients your bones need
Calcium is important, but bone health is much more complex than calcium alone. Our bodies rely on a wide range of nutrients, including magnesium, vitamin D, vitamin K, vitamin C, zinc, and adequate protein, to support normal bone metabolism. I outline the 20 key bone nutrients in more detail. These nutrients work together, and the goal is to meet individual needs rather than simply taking larger doses of supplements.
I encourage women to evaluate their diet, laboratory findings, medical history, and supplement use with a knowledgeable healthcare professional.
5. Don’t overlook sleep, stress, and recovery
We cannot separate physical health from emotional well-being. Chronic stress, poor sleep, and inadequate recovery can influence many aspects of our physiology and daily functioning. Throughout my work, I have encouraged women to develop practices that help calm the nervous system and support resilience. These might include meditation, gentle yoga, time outdoors, meaningful social connections, and a consistent sleep routine.
Supporting healthy aging is not simply about doing more. Sometimes it is about creating the conditions in which the body can function at its best.
Could a Routine Chest CT Reveal Hidden Bone Loss?
One of the most promising practical aspects of this research is the imaging technology itself. The researchers used deep learning to identify bone density information already contained in chest CT scans. Many adults undergo these scans for lung screening or other medical reasons, and the images often include portions of the thoracic spine. This raises an intriguing possibility: Could we use information from existing scans to identify people who might benefit from further bone health evaluation?
Potentially, yes. Opportunistic bone assessment from CT scans is an active area of research, and it could eventually help identify some individuals whose low bone density might otherwise go unnoticed. (For another example of AI in bone health, see this AI hip fracture prediction tool.) However, the measurements in this study were research measurements. They do not automatically replace standard osteoporosis evaluation, and the study did not establish that using CT-derived bone density improves dementia screening.
If you’ve had a chest CT and are concerned about your bone health, you can ask your healthcare provider whether the images or radiology report contain useful information about your spine. Further evaluation may be appropriate depending on your age, medical history, fracture risk, and previous testing.
The Bigger Lesson: Strong Bones Are Part of a Stronger You
After more than four decades of studying bone health, one lesson continues to stand out to me: We cannot fully understand the skeleton without understanding the person. Our bones respond to how we eat, move, rest, and maintain our overall health. This new research adds another fascinating observation: lower bone density may accompany certain patterns of accelerated brain aging. But rather than viewing this as another reason to fear osteoporosis, I see it as encouragement to take a broader view of healthy aging.
Your bone density measurement is one important piece of information. It is not the whole story of your health. We need more research to understand why bone and brain changes appear together and whether interventions targeting shared metabolic risk factors can improve long-term outcomes. In the meantime, we already have meaningful reasons to nourish our bodies, maintain muscle strength, address metabolic risk factors, and remain physically and mentally engaged.
My message is simple: Don’t focus only on your bones. Support the whole person who lives within them.
Frequently Asked Questions About Bone Density and Brain Health
Does low bone density cause dementia?
No. The study found an association between lower spinal bone density and faster cognitive decline, but it was observational and did not show that one condition causes the other.
What did the new Radiology study find?
Among 715 older adults in the MESA cohort, lower thoracic vertebral bone density was associated with faster decline in global cognition and with certain white matter changes, including in the corpus callosum.
Could improving my bone density protect my brain?
We cannot conclude that. Participants were not treated to improve bone density, so the study cannot show that raising bone density prevents dementia or reverses brain changes.
Why might bone and brain health be connected?
The researchers propose shared metabolic influences such as insulin resistance, abnormal blood lipids, and menopausal changes. These are proposed explanations, not mechanisms proven by this study.
Is a chest CT bone measurement the same as a DEXA scan?
No. The study measured volumetric bone density in the thoracic spine from CT images, which is different from the hip and lumbar spine T-scores reported on a DEXA scan.
Learn My Six-Step Approach to Building Stronger Bones Naturally
If this research has you thinking more deeply about your bone health, I invite you to explore my Better Bones Solution Masterclass. I’ve brought together the key principles from my 40-plus years of research and clinical experience into a practical, step-by-step program designed to help you understand your bones and take an active role in your health.
Inside the course, you’ll learn about:
- Assessing your individual bone health situation
- The alkaline-forming diet and dietary acidâalkaline balance
- The 20 key nutrients involved in bone health
- Digestion, absorption, and detoxification
- Safe, effective bone-building exercise
- Stress reduction and mind-body resilience
You’ll receive more than 18 hours of educational content, a comprehensive workbook, and lifetime access so you can learn at your own pace. Your bones are living tissue, and they deserve a whole-body approach.
Explore Dr. Brown’s Better Bones Solution Masterclass
Scientific Reference
Momtazmanesh S, et al. Deep Learningâderived Bone Mineral Density and Longitudinal White Matter Microstructure and Cognitive Decline: Multi-Ethnic Study of Atherosclerosis. Radiology. Published September 22, 2026. DOI: 10.1148/radiol.260656
Additional reading: Radiological Society of North America, Lower Bone Density Linked to Cognitive Decline, September 2026.
Medical disclaimer: This article is intended for educational purposes only and does not constitute individualized medical advice. The study discussed is observational and does not establish that osteoporosis causes dementia or that improving bone density prevents cognitive decline. Consult your healthcare provider regarding bone density testing, cognitive concerns, medical treatment, nutrition, and exercise.
