Fracture risk and impact of osteoporosis in patients with Parkinson’s disease: a nationwide database study

• Published in: Journal of bone and mineral metabolism 2022-07, Vol.40 (4), p.602-612
• Main Authors: Kim, Tae-lim, Byun, Seong Jun, Seong, Min Yong, Oh, Byung-Mo, Park, Sang Jun, Seo, Han Gil
• Format: Article
• Language: English
• Subjects: Fractures; Hip; Hip joint; Medicine; Medicine & Public Health; Metabolic Diseases; Movement disorders; Neurodegenerative diseases; Original Article; Orthopedics; Osteoporosis; Parkinson's disease
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-022-01322-w

Introduction Patients with Parkinson’s disease (PD) showed an increased risk of fractures in previous studies and a high prevalence of osteoporosis is reportedly a potential contributor. We conducted a nationwide database study on the risk of fractures and the impact of osteoporosis on patients with PD compared to controls. Materials and methods Using a nationwide database in South Korea, we identified incident patients with PD in 2004–2006 and selected four age- and sex-matched controls. We checked the occurrence rates of overall and hip fractures and plotted Kaplan–Meier curves and a Cox proportional hazards model to determine risk. We also conducted stratified analyses according to the presence or absence of osteoporosis. Results We identified 9126 patients with PD and 35,601 controls. Patients with PD had a greater probability of fractures throughout the study period in Kaplan–Meier curves, and an increased risk of overall (aHR 1.35, 95% CI 1.297–1.405) and hip (aHR 1.814, 95% CI 1.66–1.983) fractures in a Cox proportional hazards model. In the stratified analysis, the increased risk of overall fracture (aHR 1.333, 95% CI 1.273–1.396 and aHR 1.412, 95% CI 1.301–1.532, respectively) and hip fracture (aHR 1.773, 95% CI 1.604–1.96 and aHR 2.008, 95% CI 1.657–2.434, respectively) due to PD was similar between patients with and without osteoporosis. Discussion Patients with PD, with or without osteoporosis, are more likely to experience fractures, especially hip fractures. There seems to be no interaction between PD and osteoporosis in regard to the occurrence of fractures, and therefore no effect modification by osteoporosis.