Abstract
Background
Parkinson's disease (PD) is the fastest-growing neurological disorder globally. Defining features include tremor, muscular rigidity, bradykinesia, and postural instability, which in combination with nonmotor symptoms such as cognitive impairment and orthostatic hypotension increase the risk of falls. Along with low bone mineral density, fracture risk is high in PD.
Objectives
The aims were to identify and appraise clinical practice guidelines, consensus statements, and treatment algorithms containing recommendations for bone health in people with PD (PwP).
Methods
We systematically searched 4 electroninc databases (MEDLINE, Embase, Emcare, and Web of Science) (n = 78), in addition to the websites of organizations, societies, and professional bodies focused on PD or osteoporosis (n = 28), up to April 22, 2024.
Results
After duplicate removal, screening, and full-text review, 6 records were included. Included records were appraised using the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. All records recognized bone health as a concern in PD, yet recommendations for fracture-risk screening were inconsistent. Two of six records grouped PD under the broad category of neurological diseases. The acceptability and tolerance of anti-osteoporosis medications in PwP was discussed only in 1 record, which incorporated national osteoporosis guidelines into a PD-specific treatment algorithm.
Conclusions
This review highlights that despite the documented high fracture rates of PwP, health professionals do not always have adequate resources to support them when considering how to manage osteoporosis. Osteoporosis screening and management needs to be incorporated into PD treatment guidelines, and equally providing specific recommendations for PwP related to bone health in national osteoporosis guidelines should be a priority given the high burden of fracture in the patient population.
Parkinson's disease (PD) is the fastest-growing neurological disorder globally. Defining features include tremor, muscular rigidity, bradykinesia, and postural instability, which in combination with nonmotor symptoms such as cognitive impairment and orthostatic hypotension increase the risk of falls. Along with low bone mineral density, fracture risk is high in PD.
Objectives
The aims were to identify and appraise clinical practice guidelines, consensus statements, and treatment algorithms containing recommendations for bone health in people with PD (PwP).
Methods
We systematically searched 4 electroninc databases (MEDLINE, Embase, Emcare, and Web of Science) (n = 78), in addition to the websites of organizations, societies, and professional bodies focused on PD or osteoporosis (n = 28), up to April 22, 2024.
Results
After duplicate removal, screening, and full-text review, 6 records were included. Included records were appraised using the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. All records recognized bone health as a concern in PD, yet recommendations for fracture-risk screening were inconsistent. Two of six records grouped PD under the broad category of neurological diseases. The acceptability and tolerance of anti-osteoporosis medications in PwP was discussed only in 1 record, which incorporated national osteoporosis guidelines into a PD-specific treatment algorithm.
Conclusions
This review highlights that despite the documented high fracture rates of PwP, health professionals do not always have adequate resources to support them when considering how to manage osteoporosis. Osteoporosis screening and management needs to be incorporated into PD treatment guidelines, and equally providing specific recommendations for PwP related to bone health in national osteoporosis guidelines should be a priority given the high burden of fracture in the patient population.
| Original language | English |
|---|---|
| Number of pages | 11 |
| Journal | Movement Disorders Clinical Practice |
| Early online date | 20 Dec 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 20 Dec 2024 |