Comparing the Incidence of Falls/Fractures in Parkinson’s Disease Patients in the US Population

Abstract

Patients with Parkinson’s disease (PD) may experience falls and/or fractures as a result of disease symptoms. There are limited data available from long-term studies estimating the incidence of falls/fractures in patients with PD. The objective was to compare the incidence rate of falls/fractures in PD patients with non-PD patients in a US population. This was a retrospective study using a US-based claims database (Truven Health MarketScan®) that compared the incidence rate of falls/fractures in PD subjects with non-PD subjects. The study period included the 12 months prior to index date (defined as earliest PD diagnosis [International Classification of Diseases, Ninth Revision, Clinical Modification code 332.0]) and a postindex period to the end of data availability. Fractures were defined by inpatient/outpatient claims as a principal or secondary diagnosis and accompanying procedure codes during the postindex period. Incidence rates and 95% CIs for falls/fractures were calculated as the number of events per 10,000 person-years of follow-up using negative binomial or Poisson regression models. Twenty-eight thousand two hundred and eighty PD subjects were matched to non-PD subjects for the analysis (mean [SD] age, 71.4 [11.8] years; 53% male). A higher incidence rate (adjusted for comorbidities and medications) of all fall/fracture cases and by fall and fracture types was observed for PD subjects versus non-PD subjects; the overall adjusted incidence rate ratio comparing PD to non-PD subjects was 2.05; 95% CI, 1.88–2.24. The incidence rate of falls/fractures was significantly higher in subjects with PD compared with non-PD subjects in a US population.

Central Nervous System Agent Classes and Fragility Fracture Risk among Elderly Japanese Individuals in a Nationwide Case-Crossover Design Study

“…In addition, the case-crossover design study by Leach et al also showed an OR of 1.5 each for antipsychotics and SSRIs. 4) The use of medications such as SSRIs, 5,11,12) antipsychot- ics, 5) and high doses of levodopa 25) was reported to be an independent risk factor for fracture, but some reports showed an association between mental and nervous system disorders and fracture risk; depressive disorder 26,27) and Parkinson's disease 28) have been associated with decreased bone mineral density, and Parkinson's disease 25,29) and Alzheimer's disease 30,31) have been associated with increased fracture risk. Therefore, as described below, we think that it is difficult to exclude the possibility of confounding completely due to the disease requiring a prescription (called 'confounding by indication') from the findings of the present study.…”

The Outcomes of Total Hip Replacement in Patients with Parkinson’s Disease: Comparison of the Elective and Hip Fracture Groups

“…Most Parkinson's disease patients experience falls as a result of disease symptoms and many have recurrent episodes [ 28 ]. It was estimated that 60.5% of patients with Parkinson disease experience at least one episode and 39% have recurrent falls [ 29 ].…”

Сучасний Погляд На Остеопороз В Умовах Неврологічної Патології (Огляд Літератури)

“…However, not all fractures in these patients are fallsrelated; for instance, the vertebral fractures bear no association with falls [36]. The key predictor of fragility fractures is a low BMD [43].…”