Abstract
Background
Bone health and fracture risk reduction are increasingly recognized as important issues in Parkinson’s disease (PD). However, the evidence for fracture risk management in atypical parkinsonism (AP) is less clear. Guidance on management of bone health in PD has recently been published.
Objectives
To evaluate the outcome of fracture risk assessment in a cohort of patients with AP, compared to a population with idiopathic PD.
Methods
We did a cross-sectional study of patients with PD or AP who had fracture risk assessed at two tertiary movement disorder centres. Data on fracture risk as assessed using QFracture and FRAX were collected. To assess for the effect of age on fracture risk we compared the risks of PD and AP patients aged ≤70 and >70 years.
Results
We assessed 71 patients with AP and 267 with PD. Age, sex and body mass index were similar between groups; patients with AP were more likely to have fallen in the previous year. Major osteoporotic fracture risk was greater in patients with AP aged ≤70 compared to PD; no differences between groups were seen in those aged >70 years. 76% of those with AP, and 63% with PD, had an estimated fracture risk indicating bone-sparing treatment, but only 33% of patients with AP were receiving this where it was indicated.
Conclusion
There is scope for considerable improvement in fracture risk assessment and treatment in atypical parkinsonism, taking into account the worse prognosis of this patient group.
Bone health and fracture risk reduction are increasingly recognized as important issues in Parkinson’s disease (PD). However, the evidence for fracture risk management in atypical parkinsonism (AP) is less clear. Guidance on management of bone health in PD has recently been published.
Objectives
To evaluate the outcome of fracture risk assessment in a cohort of patients with AP, compared to a population with idiopathic PD.
Methods
We did a cross-sectional study of patients with PD or AP who had fracture risk assessed at two tertiary movement disorder centres. Data on fracture risk as assessed using QFracture and FRAX were collected. To assess for the effect of age on fracture risk we compared the risks of PD and AP patients aged ≤70 and >70 years.
Results
We assessed 71 patients with AP and 267 with PD. Age, sex and body mass index were similar between groups; patients with AP were more likely to have fallen in the previous year. Major osteoporotic fracture risk was greater in patients with AP aged ≤70 compared to PD; no differences between groups were seen in those aged >70 years. 76% of those with AP, and 63% with PD, had an estimated fracture risk indicating bone-sparing treatment, but only 33% of patients with AP were receiving this where it was indicated.
Conclusion
There is scope for considerable improvement in fracture risk assessment and treatment in atypical parkinsonism, taking into account the worse prognosis of this patient group.
| Original language | English |
|---|---|
| Pages (from-to) | 385-389 |
| Number of pages | 5 |
| Journal | Movement Disorders Clinical Practice |
| Volume | 8 |
| Issue number | 3 |
| Early online date | 31 Jan 2021 |
| DOIs | |
| Publication status | Published - 1 Apr 2021 |
Bibliographical note
Funding Information:Christopher Kobylecki has received grants from Parkinson's UK and the Michael J Fox Foundation; speaker fees from Britannia and Bial Pharma; support to attend international meetings from Abbvie. Hannah Glasse, Jigisha Amin, Celia L Gregson, report no financial disclosures. Veronica Lyell has received fees for work on educational material from Parkinson's UK. Emily J Henderson has received research funding from the National Institute of Health Research (NIHR), Parkinson's‐UK, the Gatsby Foundation. She has received travel, consultancy, and honoraria from Profile Pharma, Bial, Abbvie, and Ever pharma.
Publisher Copyright:
© 2021 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC. on behalf of International Parkinson and Movement Disorder Society.
Research Groups and Themes
- BTC (Bristol Trials Centre)
- Ageing and Movement Research Group
Keywords
- fracture risk
- Parkinson's disease
- multiple system atrophy
- progressive supranuclear palsy
- osteoporosis