Falls, fractures and bone density in Parkinson's disease - a cross-sectional study

Int J Neurosci. 2017 Apr;127(4):299-304. doi: 10.1080/00207454.2016.1206897. Epub 2016 Jul 20.

Abstract

Aim: Evidence suggests that falls and associated bone fractures are more frequent in patients suffering from Parkinson's disease (PD) than in the general population. In this cross-sectional study we evaluated the clinical and biochemical characteristics that are associated to falls, fractures and bone health in a population of PD subjects.

Materials and methods: Forty-two consecutive subjects suffering from idiopathic PD (mild-to-moderate severity) with/without falls in the previous year were included. They were characterized as regards functional independence, balance, fear of falling, bone density (ultrasound densitometry) and plasma levels of vitamin D. Twenty-one age- and sex-matched healthy subjects were evaluated as controls.

Results: We detected a greater degree of osteoporosis in PD subjects as compared to controls, more pronounced in males than in females (Z-score: M -3.8 ± 1.6, F -2.28 ± 0.92, p = 0.0006). A positive correlation was found between independence levels and bone density or vitamin D levels. Twenty seven patients (64%) reported falls in the previous year. These were associated to post-traumatic fractures in 16 subjects (59% of fallers). Women fell more than men (fallers: 20 F/7 M; non fallers: 4 F/11 M, χ² test p = 0.02), although the occurrence of post-traumatic fractures among fallers did not differ between sexes (F 11/9, M 5/2, χ² test p > 0.05). Fallers with post-traumatic fractures showed higher degrees of motor impairment.

Conclusions: These findings confirm that falls and osteoporosis represent major health issues in PD, already in the middle stages of disease.

Keywords: balance; bone density; falls; functional independence; gender; traumatic fractures.

MeSH terms

  • Accidental Falls*
  • Aged
  • Aged, 80 and over
  • Bone Density / physiology*
  • Cross-Sectional Studies
  • Densitometry
  • Fear / psychology
  • Female
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / etiology*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / blood
  • Parkinson Disease / complications*
  • Parkinson Disease / diagnostic imaging
  • Parkinson Disease / psychology
  • Postural Balance / physiology
  • Sensation Disorders / etiology
  • Severity of Illness Index
  • Sex Factors
  • Ultrasonography
  • Vitamin D / blood

Substances

  • Vitamin D