Association of Parkinson’s disease with accelerated bone loss, fractures and mortality in older men: the Osteoporotic Fractures in Men (MrOS) study
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Among community-dwelling older men, compared to those without Parkinson’s disease (PD), over approximately 5 years, those with baseline PD had a significantly greater rate of annualized total hip bone loss (−1.1% vs. 0.4%), proportion of incident non-spine fractures (14.9% vs. 7.2%) and mortality (34.8% vs. 9.5%).
The objective of this study was to examine the association of Parkinson’s disease (PD) with bone loss and fractures in older men.
This prospective cohort study analyzed data from 5,937 community dwelling men aged ≥65 years at six clinical centers of the Osteoporotic Fractures in Men (MrOS) Study. At baseline and visit two (mean interval 4.6 +/−0.4 SD years), community-diagnosed PD was ascertained by self-report and hip bone mineral density (BMD) was measured using dual energy x-ray absorptiometry (DXA). Incident fractures were self-reported. Fractures and deaths were centrally adjudicated.
At baseline, 46 (0.8%) men had PD. Age-adjusted mean annualized total hip bone loss was greater in men with vs. those without PD (−1.08% vs. −0.36%, p < 0.001). 15.2% of men with PD and 7.2% of men without PD experienced an incident non-spine fracture (age-adjusted HR 2.4, 95%CI 1.1–5.0). 34.8% of men with PD and 9.5% of men without PD died during follow-up (age-adjusted HR 3.5, 95%CI 2.2–5.5). Associations of PD with bone loss, fractures and mortality were modestly altered by additional individual adjustment for possible confounders.
In community-dwelling older men, PD was associated with increased bone loss, fractures and mortality. In addition to implementing fall prevention measures, clinicians should consider osteoporosis screening in older men with PD.
KeywordsBone density Fractures Mortality Osteoporosis Parkinson’s disease
Potential financial conflicts of interest
Dr. Schousboe receives research grant support from Hologic, Inc. Dr. Ensrud receives research grant support from Bionovo. Dr. Orwoll receives research, consulting or speaking support from Aventis, Pfizer, Eli Lilly & Co., Novartis, Merck & Co., Procter & Gamble, GlaxoSmithKline, Zelos Therapeutics Inc., Imaging Therapeutics Ind., and Solvay Pharmaceuticals. All other authors have no conflicts of interest.
Conception and design: H.A. Fink, M.A. Kuskowski
Acquisition of participants and/or data: E.S. Orwoll, K.E. Ensrud
Analysis and interpretation of the data: H.A. Fink, M.A. Kuskowski, B.C. Taylor, J.T. Schousboe, K.E. Ensrud
Drafting of the article: H.A. Fink
Critical revision of the article for important intellectual content: H.A. Fink, M.A. Kuskowski, B.C. Taylor, J.T. Schousboe, E.S. Orwoll, K.E. Ensrud
Final approval of the article: H.A. Fink, M.A. Kuskowski, B.C. Taylor, J.T. Schousboe, E.S. Orwoll, K.E. Ensrud
The funding agencies played no role in the design, analysis and preparation of this manuscript.
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