Calcium Supplements & Dementia Risk

Do you remember the famous (deeply flawed, further misreported, debunked) Women’s Health Initiative (WHI) study that misrepresented data about hormone replacement therapy (HRT), understating the benefits and overstating the risks, scaring a generation off HRT for no good reason?

If not, then here’s more detail about that: Cancer & HRT: What’s Safe?

With that in mind, guess what else WHI data has been (mis)used by third-parties to warn us against? If you guessed calcium supplementation, you guessed correctly:

❝Calcium supplements with or without vitamin D modestly increase the risk of cardiovascular events, especially myocardial infarction, a finding obscured in the WHI CaD Study by the widespread use of personal calcium supplements. A reassessment of the role of calcium supplements in osteoporosis management is warranted.❞

Source: Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis

You may be thinking: today’s title said about dementia, and this paper is about cardiovascular events, so what’s the connection?

The connection is: stroke is a cardiovascular event, and vascular dementia is a very common kind of dementia.

For much more detail on this, see: What’s Your Vascular Dementia Risk? ← includes actual numbers and a risk calculator tool and things like that

However, there’s more, for example:

❝The present study demonstrates that the use of Ca-containing dietary supplements, even low-dose supplements, by older adults may be associated with greater lesion volumes.

Evaluation of randomised controlled trials is warranted to determine whether this relationship is a causal one.❞

Source: Elevated brain lesion volumes in older adults who use calcium supplements: a cross-sectional clinical observational study

Can you see how the press might take the first line and run with it, without addressing the second line?

See also: How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

We’ve also seen things like:

❝Calcium supplementation may increase the risk of developing dementia in elderly women with cerebrovascular disease.

Because our sample was relatively small and the study was observational, these findings need to be confirmed.❞

Source: Calcium supplementation and risk of dementia in women with cerebrovascular disease

Once again, a lot of news outlets will run with the first part without mentioning the latter parts.

And sometimes, it will be a case of “the title looks damning, even if the actual conclusion isn’t”, for example:

❝There was no association between treatment assignment and incident cognitive impairment.

Further studies are needed to investigate the effects of vitamin D and calcium separately, on men, in other age and ethnic groups, and with other doses.❞

Source: Calcium and Vitamin D Supplementation and Cognitive Impairment in the Women’s Health Initiative

…which will get shared around and seen by millions of people who don’t read beyond the title and think “oh, there is an association between calcium and vitamin D supplementation and cognitive impairment, the Women’s Health Initiative says so”, when in fact none of these things are what it is saying.

And that is how rumors run around the world while the truth hasn’t even tied its shoelaces yet.

And now for the truth

A long-term analysis of 1,460 women aged 70+ has found that daily calcium supplementation did not increase dementia risk over nearly 15 years of follow-up.

Specifically,

❝Mean baseline age was 75.1 ± 2.7 years. Dementia events were recorded in 269 women (18.4%), comprising 243 hospitalisations (16.6%) or 114 deaths (7.8%). No differences in the cumulative dementia-free survival rates were observed between groups in ITT and PP analyses.

Compared to placebo, calcium supplements did not increase risk of dementia-related events (unadjusted ITT hazard ratio [HR] 0.90, 95% confidence interval (CI) 0.71–1.15), hospitalisations (HR 0.89, 95% CI 0.69–1.15) or deaths (HR 0.78, 95% CI 0.54–1.13). Similar results were observed in PP analyses.❞

As you can see, the range neatly straddles “1” in each case, meaning that on average, it neither increases nor decreases the risk. And with regard to the different analyses, what that means is that both before and after adjusting for lifestyle, dietary, and genetic factors, there continued to be no association whatsoever.

In terms of p-score (a measure of how statistically significant the results are, by expressing the probability that this could have been arrived at by chance),

❝There was no significant difference (p = 0.28) in AMS scores between the calcium (n = 569) and placebo (n = 579) groups at the end of the RCT; median (IQR): 10 (9–10) in both groups.❞

You can read the paper in full, here: Calcium supplementation and the risk of dementia in the Perth Longitudinal Study of Aging Women: a post-hoc analysis of a randomised clinical trial for fracture prevention

That was, by the way, at 1200mg/day. So, a very normal amount of calcium, and generally considered slightly above what most people need.

Want to learn more?

While it appears calcium supplementation is healthful for most people at normal levels, there are still safe limits, and connected health considerations to bear in mind at the same time:

Vit D + Calcium: Too Much Of A Good Thing? ← this also talks about safe and effective doses, and what goes wrong if you take too much

There is also a common issue that a lot of people get enough calcium and vitamin D, but then a lot of that calcium doesn’t make it past the arteries.

Thus, the calcium paradox: we want to get (usually: more) calcium, but we want it building our bones, not lining our arteries. How, then, to resolve this problem, and simultaneously fight the dual threats of calcium deficiency (osteoporosis) and calcium excess (atherosclerosis)?

The answer lies in vitamin K2, which assists the calcium in getting to where you need it, rather than having it accumulating where you don’t.

Learn more: Vitamin K2 And The Calcium Paradox

Take care!