Women with osteoporosis may be more likely to carry a gene linked to Alzheimer’s, according to new research.

Scientists found that APOE4, the most common genetic risk factor for Alzheimer’s, can weaken bone quality in women, even when standard scans appear normal.

The study, carried out by researchers at the Buck Institute for Research on Ageing in California, US, and UC San Francisco, suggests the gene may damage bone at a microscopic level long before any visible signs.

These changes can emerge as early as midlife and remain invisible to routine imaging tests used to assess bone strength.

The findings suggest a link between Alzheimer’s risk and skeletal health and could help pave the way for earlier detection of both conditions.

Professor Birgit Schilling, a senior author of the study, said: “What makes this finding so striking is that bone quality is being compromised at a molecular level that a standard bone scan simply will not catch.

“APOE4 is quietly disrupting the very cells responsible for keeping bone strong – and it is doing this specifically in females, which mirrors what we see with Alzheimer’s disease risk.”

Doctors have long observed that people with Alzheimer’s suffer higher rates of bone fractures, while osteoporosis in women is known to be one of the earliest predictors of the disease.

Now scientists believe they may have uncovered why.

Researchers led by Dr Charles Schurman carried out a detailed analysis of proteins in aged mouse bone and found that tissue was unusually rich in molecules linked to neurological disease, including those associated with Alzheimer’s.

In particular, long-lived bone cells known as osteocytes showed elevated levels of APOE, with levels twice as high in older female mice compared with younger or male animals.

Further experiments using genetically modified mice revealed that APOE4 had a strong and sex-specific impact on both bone and brain tissue.

The disruption at the protein level was even greater in bone than in the brain.

However, the bone structure itself appeared completely normal under scans.

Instead, the gene interfered with a key maintenance process inside bone cells, preventing them from repairing microscopic channels that keep bones strong and resilient.

When this process breaks down, bones become more fragile even if they look healthy on standard imaging.

These results suggest bone cells could potentially act as early biological warning signs of cognitive decline in women carrying APOE4.

Professor Lisa Ellerby, another senior author, said: “We think targeting these cells may open a new front in preserving bone quality in this population.”

Experts say the findings highlight the need to view the body as an interconnected system rather than treating diseases in isolation.

Dementia, of which Alzheimer’s is the most common form, remains one of the UK’s biggest health challenges.

Around 900,000 people are currently living with the condition, a figure expected to rise to 1.6 million by 2040.

It is already the leading cause of death, responsible for more than 74,000 deaths each year.

Future Fertility, a Toronto-based health technology company specialising in AI-powered fertility insights, has entered the Japanese market through a new commercial partnership with Kato Ladies Clinic — a globally recognised leader in IVF research and advancing clinical fertility care.

The collaboration marks Future Fertility’s first partnership in Japan and reflects growing global demand for technologies that bring greater objectivity and personalisation to fertility care.

Kato Ladies Clinic will integrate the company’s AI-powered oocyte (egg) quality assessment tools into its clinical workflows, with the aim of supporting more informed treatment planning and patient counselling across IVF and egg freezing cycles.

“At Kato Ladies Clinic, we are committed to advancing fertility care through innovation while maintaining a strong focus on individualised, patient-centred treatment,” said Keiichi Kato, chief executive officer.

“Partnering with Future Fertility enables us to integrate objective, data-driven insights into our clinical approach and better support our patients in making informed decisions.”

Future Fertility’s platform analyses images of oocytes using artificial intelligence trained and validated on a dataset of more than 650,000 unique oocyte images.

The technology is already in use at more than 300 clinics across more than 35 countries, helping clinicians better understand the developmental potential of individual eggs and provide patients with more personalised insight earlier in their treatment journey.

From Research Collaboration to Clinical Adoption

The partnership between Future Fertility and Kato Ladies Clinic began as a scientific research collaboration in 2024, marking the first use of AI-powered oocyte quality assessment in Japan.

The collaboration not only validated the technology in a new patient population and across diverse clinical protocols — including minimal stimulation cycles —but also resulted in a peer-reviewed publication in Reproductive BioMedicine Online (RBMO) and a poster abstract presentation at ESHRE 2025.

The joint research explored how AI-derived oocyte quality scores relate to early embryonic development and overall treatment outcomes. In a retrospective study conducted at Kato Ladies Clinic, researchers analysed nearly 2,800 mature oocytes across more than 1,300 ICSI cycles, linking image-based assessments of egg quality to key developmental milestones.

The study demonstrated that lower AI scores were associated with reduced fertilization rates, delays, and abnormalities in early embryo development, increased developmental errors, and lower-quality blastocyst formation.

Notably, the researchers also found that cumulative oocyte scores were a stronger predictor of live birth outcomes than the number of eggs retrieved — underscoring the importance of assessing egg quality alongside quantity.

“Our collaboration with Future Fertility has demonstrated how artificial intelligence can uncover meaningful biological differences between oocytes that were previously difficult to quantify,” said Kenji Ezoe, senior scientist.

“Bringing this technology into routine clinical use is an important step toward translating research into improved patient outcomes.”

Future Fertility’s VP of clinical embryology & scientific operations, Jullin Fjeldstad, noted that the findings provide important clinical validation.

“Our joint research with Kato Ladies Clinic has shown how AI-based oocyte assessment can be directly linked to numerous embryo development outcomes, from fertilization through early developmental milestones and blastocyst formation,” she said.

“We are excited to see this work translated into clinical practice.”

Growing Demand for Fertility Care in Japan

The partnership comes at a time when demand for fertility treatment in Japan continues to rise.

The country performs over 450,000 fertility treatment cycles annually, making it one of the largest markets globally. Delayed childbearing and evolving societal trends have also contributed to increasing interest in egg freezing.

As patients seek more clarity and personalization in their care, tools that provide earlier insight into reproductive potential are gaining traction.

“Entering the Japanese market with a partner like Kato Ladies Clinic is a significant step forward for our global commercial strategy,” said Rafael Gonzalez, Future Fertility’s VP of global sales & strategy.

“It reflects the growing demand for technologies that support more transparent, data-driven fertility care across diverse healthcare systems.”

Expanding a Global Footprint

Founded in 1993, Kato Ladies Clinic is known for its pioneering work in natural and minimal stimulation IVF and has long been a leader in clinical innovation in Japan.

For Future Fertility, the partnership represents both a geographic expansion and a continuation of its broader mission to bring AI-driven insights into routine fertility care.

“We are proud to partner with Kato Ladies Clinic, a globally respected leader in IVF and a pioneer in reproductive medicine in Japan,” said Future Fertility’s CEO, Christy Prada.

“This partnership represents an important milestone as we expand into Asia and continue our mission to bring objective, personalised insights into fertility care worldwide.”

Future Fertility develops AI-powered tools designed to generate personalised insights across the fertility journey.

Its flagship oocyte assessment technologies analyse egg images to provide objective, individualised measures of egg quality, supporting treatment planning, patient counselling, and clinical decision-making in egg freezing and IVF, while also enabling more data-driven approaches to donor egg distribution and quality assurance.

As fertility care continues to evolve, collaborations like this one are helping shape a new standard — one that emphasises earlier insight, greater transparency, and more personalised decision-making for patients navigating increasingly complex reproductive journeys.