Abstract
Postural instability, a core feature of parkinsonism, leads to an increased risk of falls and fractures. However, the risk of fracture has not been assessed in an incident cohort of Parkinson's disease and atypical parkinsonism.
Objectives
We determined the absolute and relative fracture risk and predictive variables in a prospective incident cohort of parkinsonian patients and controls.
Methods
Fracture data for 326 incident parkinsonian cases (198 Parkinson's disease, 128 atypical parkinsonism) and 261 controls was recorded annually in the Parkinsonism Incidence in North-East Scotland study. Incidence rates were determined for all fractures and major fractures. Kaplan-Meier curves were used to determine time to first fracture for each group. Stepwise, multivariate Cox regression analysis was used to identify risk factors for fracture in parkinsonian patients.
Results
Mean age at recruitment was 74.5 years in all parkinsonian patients (age at diagnosis) and 75 years in controls. The incidence of any fracture was 5.5 (95% CI 4.3–7.0) and 2.0 (1.3–2.9)/100 participant-years for the parkinsonian and control groups respectively, whilst for major fractures due to falls it was 4.2 (3.2–5.5) and 1.4 (0.9–2.2)/100 participant-years respectively. Independent predictors for fractures in parkinsonian patients were osteoporosis, female gender and falling during the follow up period. There was no difference in fracture rates between those with Parkinson's disease and atypical parkinsonism.
Conclusion
The fracture rate in parkinsonism from the time of diagnosis (about 5% per year) is over three times greater than controls. Fracture risk should be routinely assessed in all parkinsonian patients.
| Original language | English |
|---|---|
| Pages (from-to) | 60-65 |
| Number of pages | 6 |
| Journal | Parkinsonism & Related Disorders |
| Volume | 29 |
| Early online date | 26 May 2016 |
| DOIs | |
| Publication status | Published - Aug 2016 |
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Keywords
- Aged
- Aged, 80 and over
- Cohort Studies
- Female
- Fractures, Bone/epidemiology
- Humans
- Kaplan-Meier Estimate
- Male
- Parkinson Disease/epidemiology
- Parkinsonian Disorders/epidemiology
- Risk Factors
- Statistics, Nonparametric
Cite this
Risk of fracture amongst patients with Parkinson's disease and other forms of parkinsonism. / Sleeman, Isobel; Che, Zhu Chung; Counsell, Carl.
In: Parkinsonism & Related Disorders, Vol. 29, 08.2016, p. 60-65.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk of fracture amongst patients with Parkinson's disease and other forms of parkinsonism
AU - Sleeman, Isobel
AU - Che, Zhu Chung
AU - Counsell, Carl
N1 - Acknowledgements We thank all the participants who took part, the research fellows (Kate Taylor, Robert Caslake, David McGhee, Angus Macleod) and nurses (Clare Harris, Joanna Gordon, Anne Hayman, Hazel Forbes) who helped assess the participants, and the study secretaries (Susan Kilpatrick, Pam Rebecca) and data management team (Katie Wilde, David Ritchie). The PINE study was funded by the BMA Doris Hillier award, Parkinson's UK, the RS McDonald Trust, NHS Grampian Endowments, SPRING and the BUPA Foundation. None of the funders had any influence in the study design, the collection, analysis and interpretation of the data, the writing of the report or the decision to submit the article for publication.
PY - 2016/8
Y1 - 2016/8
N2 - IntroductionPostural instability, a core feature of parkinsonism, leads to an increased risk of falls and fractures. However, the risk of fracture has not been assessed in an incident cohort of Parkinson's disease and atypical parkinsonism.ObjectivesWe determined the absolute and relative fracture risk and predictive variables in a prospective incident cohort of parkinsonian patients and controls.MethodsFracture data for 326 incident parkinsonian cases (198 Parkinson's disease, 128 atypical parkinsonism) and 261 controls was recorded annually in the Parkinsonism Incidence in North-East Scotland study. Incidence rates were determined for all fractures and major fractures. Kaplan-Meier curves were used to determine time to first fracture for each group. Stepwise, multivariate Cox regression analysis was used to identify risk factors for fracture in parkinsonian patients.ResultsMean age at recruitment was 74.5 years in all parkinsonian patients (age at diagnosis) and 75 years in controls. The incidence of any fracture was 5.5 (95% CI 4.3–7.0) and 2.0 (1.3–2.9)/100 participant-years for the parkinsonian and control groups respectively, whilst for major fractures due to falls it was 4.2 (3.2–5.5) and 1.4 (0.9–2.2)/100 participant-years respectively. Independent predictors for fractures in parkinsonian patients were osteoporosis, female gender and falling during the follow up period. There was no difference in fracture rates between those with Parkinson's disease and atypical parkinsonism.ConclusionThe fracture rate in parkinsonism from the time of diagnosis (about 5% per year) is over three times greater than controls. Fracture risk should be routinely assessed in all parkinsonian patients.
AB - IntroductionPostural instability, a core feature of parkinsonism, leads to an increased risk of falls and fractures. However, the risk of fracture has not been assessed in an incident cohort of Parkinson's disease and atypical parkinsonism.ObjectivesWe determined the absolute and relative fracture risk and predictive variables in a prospective incident cohort of parkinsonian patients and controls.MethodsFracture data for 326 incident parkinsonian cases (198 Parkinson's disease, 128 atypical parkinsonism) and 261 controls was recorded annually in the Parkinsonism Incidence in North-East Scotland study. Incidence rates were determined for all fractures and major fractures. Kaplan-Meier curves were used to determine time to first fracture for each group. Stepwise, multivariate Cox regression analysis was used to identify risk factors for fracture in parkinsonian patients.ResultsMean age at recruitment was 74.5 years in all parkinsonian patients (age at diagnosis) and 75 years in controls. The incidence of any fracture was 5.5 (95% CI 4.3–7.0) and 2.0 (1.3–2.9)/100 participant-years for the parkinsonian and control groups respectively, whilst for major fractures due to falls it was 4.2 (3.2–5.5) and 1.4 (0.9–2.2)/100 participant-years respectively. Independent predictors for fractures in parkinsonian patients were osteoporosis, female gender and falling during the follow up period. There was no difference in fracture rates between those with Parkinson's disease and atypical parkinsonism.ConclusionThe fracture rate in parkinsonism from the time of diagnosis (about 5% per year) is over three times greater than controls. Fracture risk should be routinely assessed in all parkinsonian patients.
KW - Aged
KW - Aged, 80 and over
KW - Cohort Studies
KW - Female
KW - Fractures, Bone/epidemiology
KW - Humans
KW - Kaplan-Meier Estimate
KW - Male
KW - Parkinson Disease/epidemiology
KW - Parkinsonian Disorders/epidemiology
KW - Risk Factors
KW - Statistics, Nonparametric
U2 - 10.1016/j.parkreldis.2016.05.026
DO - 10.1016/j.parkreldis.2016.05.026
M3 - Article
VL - 29
SP - 60
EP - 65
JO - Parkinsonism & Related Disorders
JF - Parkinsonism & Related Disorders
SN - 1353-8020
ER -