Abstract
Summary
Among community-dwelling older women, compared to those without Parkinson’s disease (PD), women with PD have 7.3% lower BMD and an increased risk for hip fracture (HR = 2.6).
Introduction
Studies reporting an association of Parkinson’s disease (PD) with low bone mineral density (BMD) and increased fracture risk often have been prone to selection bias, and have not accounted for potentially important explanatory variables, including recent weight loss. Further, little is known about the association between PD and non-hip fractures. Consequently, we investigated the independent association of PD with hip BMD and long-term fracture risk.
Methods
Associations of self-reported PD with hip BMD and incident hip and non-spine, non-hip fracture were analyzed using linear regression and Cox proportional hazards, respectively. This prospective cohort study analyzed 8,105 older women with known PD status (n = 73 with PD) at four US clinical centers of the Study of Osteoporotic Fractures.
Results
Compared to women without PD, age-adjusted mean total hip BMD was 7.3% lower in women with PD. Women with PD had a 2.6-fold higher age-adjusted risk for incident hip fracture. Parkinson’s disease was not significantly associated with non-spine, non-hip fractures.
Conclusions
In age-adjusted models, women with PD had lower hip BMD and increased hip fracture risk, associations that were no longer significant after further weight and multivariate adjustment. Older women with PD should be considered for evaluation and treatment to reduce their fracture risk.
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Funding sources
The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the National Institute on Aging (NIA) under the following grant numbers: AG05407, AR35582, AG05394, AR35584, AR35583, R01 AG005407, R01 AG027576-22, 2 R01 AG005394-22A1, and 2 R01 AG027574-22A1.
Potential financial conflicts of interest
Dr. Ensrud receives research grant support from Bionovo. Dr. Cummings receives research, consulting, and speaking support from Pfizer, Eli Lilly & Co., Roche, Amgen, Merck, Zelos Therapeutics Inc, Tethys, and Organon. All other authors have no conflicts of interest.
Author contributions
Conception and design: J.L. Schneider, S.R. Cummings
Acquisition of participants and/or data: S.R. Cummings, K.E. Ensrud
Analysis and interpretation of the data: J.L. Schneider, S.K. Ewing, H.A. Fink, K.E. Ensrud, S.R. Cummings
Drafting of the article: J.L. Schneider
Critical revision of the article for important intellectual content: J.L. Schneider, H.A. Fink, K.E. Ensrud, S.R. Cummings
Final approval of the article: J.L. Schneider, H.A. Fink, S.K. Ewing, K.E. Ensrud, S.R. Cummings
Sponsor’s role
The funding agencies played no role in the design, analysis and preparation of this manuscript.
Investigators in the Study of Osteoporotic Fractures Research Group: San Francisco Coordinating Center (California Pacific Medical Center Research Institute and University of California San Francisco): SR Cummings (principal investigator), MC Nevitt (co-investigator), DC Bauer (co-investigator), DM Black (co-investigator), KL Stone (co-investigator), W Browner (co-investigator), R Benard, T Blackwell, PM Cawthon, L Concepcion, M Dockrell, S Ewing, C Fox, R Fullman, SL Harrison, M Jaime-Chavez, L Lui, L Palermo, M Rahorst, D Robertson, C Schambach, R Scott, C Yeung, J Ziarno
University of Maryland: MC Hochberg (principal investigator), L Makell (clinic coordinator), MA Walsh, B Whitkop.
University of Minnesota: KE Ensrud (principal investigator), S Diem (co-investigator), M Homan (co-investigator), D King (Program Coordinator), N Michels (Clinic Director), S Fillhouer (Clinic Coordinator), C Bird, D Blanks, C Burckhardt, F Imker-Witte, K Jacobson, K Knauth, N Nelson, M Slindee.
University of Pittsburgh: JA Cauley (principal investigator), LH Kuller (co-principal investigator), JM Zmuda (co-investigator), L Harper (project director), L Buck (clinic coordinator), C Bashada, W Bush, D Cusick, A Flaugh, A Githens, M Gorecki, D Moore, M Nasim, C Newman, N Watson.
The Kaiser Permanente Center for Health Research, Portland, Oregon: T Hillier (principal investigator), E Harris (co-investigator), E Orwoll (co-investigator), K Vesco (co-investigator), J Van Marter (project director), M Rix (clinic coordinator), A MacFarlane, K Pedula, J Rizzo, K Snider, T Suvalcu-constantin, J Wallace.
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Schneider, J.L., Fink, H.A., Ewing, S.K. et al. The association of Parkinson’s disease with bone mineral density and fracture in older women. Osteoporos Int 19, 1093–1097 (2008). https://doi.org/10.1007/s00198-008-0583-5
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DOI: https://doi.org/10.1007/s00198-008-0583-5