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The aim of this study is to determine the association between eBMD and incident dementia in older adults.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective cohort study employs UK Biobank data of 131,030 adults aged\u2009\u2265\u200960 years without dementia at baseline. Cox proportional-hazards models were used to investigate the association between eBMD and incident dementia, with the C-index evaluating the discriminative potential of eBMD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among participants (52.1% women, median [IQR] age was 64 [62\u201366] years), there were 4,572 cases (3.5%) of incident dementia. Minimal model showed that participants with low eBMD (&lt;\u20090.467\u00a0g\/cm<jats:sup>2<\/jats:sup>) had a 14% increase in the rate of dementia incidence (HR 1.14, 95% CI 1.06\u20131.23; <jats:italic>P<\/jats:italic>\u2009&lt;.001), and each standard deviation (SD) decrease in eBMD was associated with a 49% increase in dementia risk (HR 1.49, 95% CI 1.19\u20131.86; <jats:italic>P<\/jats:italic>\u2009&lt;.001). Such association remained significant after further adjustment for potential confounders. Stratified analyses revealed that lower eBMD increased dementia risk in male participants (HR 1.17, 95% CI 1.06\u20131.31; <jats:italic>P<\/jats:italic>\u2009=.003) and in participants with neutral (HR 1.18, 95% CI 1.05\u20131.33; <jats:italic>P<\/jats:italic>\u2009=.007) or low genetic risk (HR 1.36, 95% CI 1.01\u20131.83; <jats:italic>P<\/jats:italic>\u2009=.04). Sensitivity analyses showed similar results. However, discriminative analyses showed minimal improvement after adding eBMD to dementia prediction models.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Lower heel eBMD is independently associated with increased dementia risk among older adults.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40520-025-03100-w","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T14:31:45Z","timestamp":1752676305000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of heel bone mineral density with incident dementia among ageing adults: a population-based study from the UK Biobank"],"prefix":"10.1007","volume":"37","author":[{"given":"Jun","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Mastaglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9120-7562","authenticated-orcid":false,"given":"Andrew Chi Pang","family":"Tai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max K.","family":"Bulsara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William G.","family":"Blakeney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Inderjeeth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1185-4768","authenticated-orcid":false,"given":"Minghao","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-4654","authenticated-orcid":false,"given":"Jun","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"3100_CR1","unstructured":"Organization WH (2023) Dementia.; Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dementia"},{"key":"3100_CR2","unstructured":"Foundation IO (2024) Epidemiology of Osteoporosis and Fractures.; Available from: https:\/\/www.osteoporosis.foundation\/facts-statistics"},{"issue":"41","key":"3100_CR3","doi-asserted-by":"publisher","first-page":"e12755","DOI":"10.1097\/MD.0000000000012755","volume":"97","author":"HG Kang","year":"2018","unstructured":"Kang HG et al (2018) Bone mineral loss and cognitive impairment: the PRESENT project. 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