Abstract
Background: Idiopathic Parkinson’s disease (IPD) increases fall risk and is associated with osteoporosis and fragility fractures (FF). Despite the high risk of adverse outcomes from untreated osteoporosis in IPD patients, bone health is clinically overlooked. This study aimed to evaluate the adequacy of bone health assessment among Aneurin Bevan University Health Board (ABUHB) patients.
Methods: This observational cohort study retrospectively analysed data from IPD patients at the ABUHB movement disorder clinic, between May 2022 and January 2024. Data collected included: demographics, disease severity, FF, FRAX® score, and bone protection. Clinic letters were also reviewed for mentions of bone health.
Results: The study included 57 patients with a mean age of 78.5 years; 70.2% were male. The mean Charlson Comorbidity Index was 5.1 and the mean Hoen and Yarh score was 2.3. Of these patients, 24.6% had osteopenia/osteoporosis, 36.8% had >0 FF, and 3.5% had fractures before PD diagnosis. The mean time from IPD diagnosis to the first FF was 3 years and 7 months. The mean duration of IPD diagnosis was 5.75 years, with those having FF showing a mean duration of 7.12 years compared to 5.21 years for those without FF. 75% of fractures were major osteoporotic fractures. Bone protection was used by 14% of patients: 100% of high-risk, 21.0% of moderate-risk, and 8.10% of low-risk patients (based on FRAX® scores). Bone health was mentioned in 22.8% of all clinic letters and in 33.3% of letters for those with >0 fragility fractures.
Conclusion: There is a positive correlation between the duration of IPD and the occurrence of FF. The study highlights a need to improve bone health management in IPD patients, especially those at moderate risk of fractures, as only 21.0% of moderate-risk patients are receiving bone protection. Increased awareness of bone health in this cohort must be promoted.