Skip to main content

Advertisement

Log in

The association of Parkinson’s disease with bone mineral density and fracture in older women

  • Case Report
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Among community-dwelling older women, compared to those without Parkinson’s disease (PD), women with PD have 7.3% lower BMD and an increased risk for hip fracture (HR = 2.6).

Introduction

Studies reporting an association of Parkinson’s disease (PD) with low bone mineral density (BMD) and increased fracture risk often have been prone to selection bias, and have not accounted for potentially important explanatory variables, including recent weight loss. Further, little is known about the association between PD and non-hip fractures. Consequently, we investigated the independent association of PD with hip BMD and long-term fracture risk.

Methods

Associations of self-reported PD with hip BMD and incident hip and non-spine, non-hip fracture were analyzed using linear regression and Cox proportional hazards, respectively. This prospective cohort study analyzed 8,105 older women with known PD status (n = 73 with PD) at four US clinical centers of the Study of Osteoporotic Fractures.

Results

Compared to women without PD, age-adjusted mean total hip BMD was 7.3% lower in women with PD. Women with PD had a 2.6-fold higher age-adjusted risk for incident hip fracture. Parkinson’s disease was not significantly associated with non-spine, non-hip fractures.

Conclusions

In age-adjusted models, women with PD had lower hip BMD and increased hip fracture risk, associations that were no longer significant after further weight and multivariate adjustment. Older women with PD should be considered for evaluation and treatment to reduce their fracture risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Parkinson’s Disease Foundation. Parkinson’s Disease Foundation website 2007;

  2. Taggart H, Crawford V (1995) Reduced bone density of the hip in elderly patients with Parkinson’s disease. Age Ageing 24:326–328

    Article  PubMed  CAS  Google Scholar 

  3. Sato Y, Kaji M, Tsuru T, Oizumi K (2001) Risk factors for hip fracture among elderly patients with Parkinson’s disease. J Neurol Sci 182:89–93

    Article  PubMed  CAS  Google Scholar 

  4. Fink HA, Kuskowski MA, Orwoll ES, Cauley JA, Ensrud KE (2005) Association between Parkinson’s disease and low bone density and falls in older men: the osteoporotic fractures in men study. J Am Geriatr Soc 53:1559–1564

    Article  PubMed  Google Scholar 

  5. Johnell O, Melton LJ III, Atkinson EJ, O’Fallon WM, Kurland LT (1992) Fracture risk in patients with parkinsonism: a population-based study in Olmsted County, Minnesota. Age Ageing 21:32–38

    Article  PubMed  CAS  Google Scholar 

  6. Genever RW, Downes TW, Medcalf P (2005) Fracture rates in Parkinson’s disease compared with age- and gender-matched controls: a retrospective cohort study. Age Ageing 34:21–24

    Article  PubMed  Google Scholar 

  7. Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O’Brien LA, Hoffman S, Kaplan F (1991) Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med 324:1326–1331

    Article  PubMed  CAS  Google Scholar 

  8. Taylor BC, Schreiner PJ, Stone KL, Fink HA, Cummings SR, Nevitt MC, Bowman PJ, Ensrud KE (2004) Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc 52:1479–1486

    Article  PubMed  Google Scholar 

  9. Cummings SR, Nevitt MC, Browner WS, Stone K, Fox KM, Ensrud KE, Cauley J, Black D, Vogt TM (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332:767–773

    Article  PubMed  CAS  Google Scholar 

  10. Nevitt MC, Cummings SR, Browner WS, Seeley DG, Cauley JA, Vogt TM, Black DM (1992) The accuracy of self-report of fractures in elderly women: evidence from a prospective study. Am J Epidemiol 135:490–499

    PubMed  CAS  Google Scholar 

  11. Sheikh JI, Yesavage JA (1996) Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. 165–73

  12. Fox KM, Cummings SR, Williams E, Stone K (2000) Femoral neck and intertrochanteric fractures have different risk factors: a prospective study. Osteoporos Int 11:1018–1023

    Article  PubMed  CAS  Google Scholar 

  13. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, Tracy JK, Hochberg MC, Rodondi N, Cawthon PM (2007) Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 62:744–751

    PubMed  Google Scholar 

  14. Simpson CF, Boyd CM, Carlson MC, Griswold ME, Guralnik JM, Fried LP (2004) Agreement between self-report of disease diagnoses and medical record validation in disabled older women: factors that modify agreement. J Am Geriatr Soc 52:123–127

    Article  PubMed  Google Scholar 

  15. Schrag A, Ben-Shlomo Y, Quinn N (2002) How valid is the clinical diagnosis of Parkinson’s disease in the community. J Neurol Neurosurg Psychiatry 73:529–534

    Article  PubMed  CAS  Google Scholar 

Download references

Funding sources

The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the National Institute on Aging (NIA) under the following grant numbers: AG05407, AR35582, AG05394, AR35584, AR35583, R01 AG005407, R01 AG027576-22, 2 R01 AG005394-22A1, and 2 R01 AG027574-22A1.

Potential financial conflicts of interest

Dr. Ensrud receives research grant support from Bionovo. Dr. Cummings receives research, consulting, and speaking support from Pfizer, Eli Lilly & Co., Roche, Amgen, Merck, Zelos Therapeutics Inc, Tethys, and Organon. All other authors have no conflicts of interest.

Author contributions

Conception and design: J.L. Schneider, S.R. Cummings

Acquisition of participants and/or data: S.R. Cummings, K.E. Ensrud

Analysis and interpretation of the data: J.L. Schneider, S.K. Ewing, H.A. Fink, K.E. Ensrud, S.R. Cummings

Drafting of the article: J.L. Schneider

Critical revision of the article for important intellectual content: J.L. Schneider, H.A. Fink, K.E. Ensrud, S.R. Cummings

Final approval of the article: J.L. Schneider, H.A. Fink, S.K. Ewing, K.E. Ensrud, S.R. Cummings

Sponsor’s role

The funding agencies played no role in the design, analysis and preparation of this manuscript.

Investigators in the Study of Osteoporotic Fractures Research Group: San Francisco Coordinating Center (California Pacific Medical Center Research Institute and University of California San Francisco): SR Cummings (principal investigator), MC Nevitt (co-investigator), DC Bauer (co-investigator), DM Black (co-investigator), KL Stone (co-investigator), W Browner (co-investigator), R Benard, T Blackwell, PM Cawthon, L Concepcion, M Dockrell, S Ewing, C Fox, R Fullman, SL Harrison, M Jaime-Chavez, L Lui, L Palermo, M Rahorst, D Robertson, C Schambach, R Scott, C Yeung, J Ziarno

University of Maryland: MC Hochberg (principal investigator), L Makell (clinic coordinator), MA Walsh, B Whitkop.

University of Minnesota: KE Ensrud (principal investigator), S Diem (co-investigator), M Homan (co-investigator), D King (Program Coordinator), N Michels (Clinic Director), S Fillhouer (Clinic Coordinator), C Bird, D Blanks, C Burckhardt, F Imker-Witte, K Jacobson, K Knauth, N Nelson, M Slindee.

University of Pittsburgh: JA Cauley (principal investigator), LH Kuller (co-principal investigator), JM Zmuda (co-investigator), L Harper (project director), L Buck (clinic coordinator), C Bashada, W Bush, D Cusick, A Flaugh, A Githens, M Gorecki, D Moore, M Nasim, C Newman, N Watson.

The Kaiser Permanente Center for Health Research, Portland, Oregon: T Hillier (principal investigator), E Harris (co-investigator), E Orwoll (co-investigator), K Vesco (co-investigator), J Van Marter (project director), M Rix (clinic coordinator), A MacFarlane, K Pedula, J Rizzo, K Snider, T Suvalcu-constantin, J Wallace.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to J. L. Schneider.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schneider, J.L., Fink, H.A., Ewing, S.K. et al. The association of Parkinson’s disease with bone mineral density and fracture in older women. Osteoporos Int 19, 1093–1097 (2008). https://doi.org/10.1007/s00198-008-0583-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-008-0583-5

Keywords

Navigation