Fracture rates in Parkinson's disease compared with age- and gender-matched controls: a retrospective cohort study

Abstract

The risk of fracture is significantly increased in PD relative to patients with other medical conditions. Hip fractures are commonly fatal in older people and partly preventable. Prospective studies of intervention to prevent fractures in PD are required.

Relative Mortality in U.S. Medicare Beneficiaries with Parkinson Disease and Hip and Pelvic Fractures

“…Among all individuals with hip/pelvic fracture, those with Parkinson disease had a greater risk of death (adjusted [5][6][7] , little is known about the factors associated with the post-hip fracture mortality of these individuals. Similar to what has been found in the general population, men with Parkinson disease demonstrated a higher risk of death than women.…”

“…While dopaminergic therapy improves tremor and rigidity, symptoms such as bradykinesia, freezing when walking, and impaired balance may remain, resulting in an increased risk of falls and injury 4,5 . People with Parkinson disease are particularly susceptible to hip fractures [5][6][7] , with a 3.2-fold greater risk compared with the risk for people without Parkinson disease 8 . In addition to gait disturbances and postural instability, other factors such as postural hypotension, decreased bone mineral density 9,10 , low vitamin-D levels 11,12 , dementia 8 , medications 5 , and advanced age 8 further increase the fracture risk for people with Parkinson disease.…”

The scientific and clinical basis for the treatment of Parkinson disease (2009)

“…9 Compared with age-matched controls, patients with PD had twice the frequency of fractures, with the most common site being the femur. 844 There are many causes of falling in patients with PD. In one study, falls in patients with PD were related to unstable posture (29.0%), freezing or festination (25.8%), sudden loss of postural reflexes (toppling falls) (25.8%), coexisting neurologic disorders (6.5%), cardiologic disorders (6.5%), and symptomatic orthostatic hypotension (3.2%).…”

Gait Disturbance Associated with Cholinergic Dysfunction in Early Parkinson's Disease

“…The anosmia group shows more serious gait disturbance than the hyposmia and normosmia groups in this study. Gait disturbance and freezing of gait are very important issues in PD because they are directly related to injury [18], loss of mobility [19], admission to nursing homes [20] and ultimately increased mortality. It is worthy of notice that this study demonstrates the associations among gait, olfaction, and the central cholinergic system in the early stage of PD.…”