Bone health in Parkinson's disease: a systematic review and meta-analysis

DEXA Bone Scan

In this large piece of work we have gathered the best quality studies in the literature to understand more about bone health and fracture risk in PD. We see that patients with Parkinson's have much poorer bone health than healthy people of the same age. The reasons why are likely multi-factorial and are also covered in this paper, and all of this is important because people with Parkinson's also have a greater risk of falls. Watch out for more of our work on bone health in Parkinson's on this blog!

J Neurol Neurosurg Psychiatry. 2014 Mar 11. doi: 10.1136/jnnp-2013-307307. [Epub ahead of print] Torsney KM, Noyce AJ, Doherty KM, Bestwick JP, Dobson R, Lees AJ.

OBJECTIVE: Parkinson's disease (PD) and osteoporosis are chronic diseases associated with increasing age. Single studies have reported associations between them and the major consequence, namely, increased risk of fractures. The aim of this systematic review and meta-analysis was to evaluate the relationship of PD with osteoporosis, bone mineral density (BMD) and fracture risk.

METHODS:

A literature search was undertaken on 4 September 2012 using multiple indexing databases and relevant search terms. Articles were screened for suitability and data extracted where studies met inclusion criteria and were of sufficient quality. Data were combined using standard meta-analysis methods.

RESULTS:

23 studies were used in the final analysis. PD patients were at higher risk of osteoporosis (OR 2.61; 95% CI 1.69 to 4.03) compared with healthy controls. Male patients had a lower risk for osteoporosis and osteopenia than female patients (OR 0.45; 95% CI 0.29 to 0.68). PD patients had lower hip, lumbar spine and femoral neck BMD levels compared with healthy controls; mean difference, -0.08, 95% CI -0.13 to -0.02 for femoral neck; -0.09, 95% CI -0.15 to -0.03 for lumbar spine; and -0.05, 95% CI -0.07 to -0.03 for total hip. PD patients were also at increased risk of fractures (OR 2.28; 95% CI 1.83 to 2.83).

CONCLUSIONS:

This systematic review and meta-analysis demonstrate that PD patients are at higher risk for both osteoporosis and osteopenia compared with healthy controls, and that female patients are at greater risk than male patients. Patients with PD also have lower BMD and are at increased risk of fractures.