Increased fracture risk in Parkinson's disease – An exploration of mechanisms and consequences for fracture prediction with FRAX

Schini, Marian; Bhatia, P; Shreef, H; Johansson, Helena; Harvey, Nicholas C; Lorentzon, Mattias; Kanis, John А.; Bandman, O; McCloskey, Eugène

doi:10.1016/j.bone.2022.116651

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…It was incorporated into country-wide recommendations for diagnosing and treating postmenopausal osteoporosis in 2017 ( 7 ). PD is not included in the FRAX list for calculating the 10-year probability of osteoporotic fractures, and the accuracy of FRAX for these individuals requires additional testing ( 22 ). The history of clinical fragility fractures in our study was investigated using a questionnaire that asked about the number and location of prior fractures, as well as their causes and outcomes.…”

Section: Methodsmentioning

confidence: 99%

Osteoporosis in Parkinson’s disease and the role of lean body mass: a cross-sectional study in a Brazilian tertiary center

Lima,

Chagas-Neto,

Gomes de Luna

et al. 2024

Front. Endocrinol.

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BackgroundParkinson’s disease (PD) is the second most common neurodegenerative illness and has the highest increase rate in recent years. There is growing evidence to suggest that PD is linked to higher osteoporosis rates and risk of fractures.ObjectiveThis study aims to estimate the prevalence and factors associated with osteoporosis as defined by the National Osteoporosis Foundation (NOF) and World Health Organization in patients with mild to moderate PD.MethodsWe performed a cross-sectional study at a tertiary public hospital in Fortaleza, Brazil, dating from May 2021 until April 2022. The study sample was comprised of patients with mild to moderate PD who were at least 40 years old and who had the ability to walk and stand unassisted. Bone Mineral Density (BMD) of both the hip (neck of the femur) and the lumbar spine were obtained via properly calibrated Dual Energy X-ray Absorptiometry (DXA) scanning. The FRAX (Fracture Risk Assessment Tool) score was used to determine a person’s 10-year risk of major osteoporotic fracture. The Revised European Working Group on Sarcopenia in Older People (EWGSOP 2) was used as a basis to confirm a sarcopenia diagnosis with the following parameters: low muscle strength gauged by handgrip strength and low muscle quantity by DXA. Physical performance was carefully evaluated by using the Short Physical Performance Battery test. Osteoporosis and osteopenia were diagnosed following the NOF guidelines and WHO recommendations.ResultsWe evaluated 107 patients in total, of whom 45 (42%) were women. The group’s mean age was 68 ± 9 years, and the mean disease time span was 9.9 ± 6.0 years and mean motor UPDRS was 43 ± 15. We found that 42.1% and 34.6% of the sample had osteopenia and osteoporosis following NOF criteria, respectively, and 43% and 33.6% following the WHO recommendations. Lower lean appendicular mass was associated to osteopenia and osteoporosis in multinomial logistic regression analysis in both diagnostic criteria.ConclusionOur findings provide additional evidence for the protective role of lean mass against osteoporosis in patients with PD.

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Section: Methodsmentioning

confidence: 99%

Osteoporosis in Parkinson’s disease and the role of lean body mass: a cross-sectional study in a Brazilian tertiary center

Lima,

Chagas-Neto,

Gomes de Luna

et al. 2024

Front. Endocrinol.

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“…A few adjustments have been proposed in cases with type 2 diabetes mellitus, including adjustment with TBS or use of the rheumatoid arthritis (RA) input [82]. A similar approach (using the RA output) has been proposed for Parkinson's disease [83]. Place of origin can also affect FRAX probabilities, as shown in a study in Sweden [84], where the hip fracture incidence for Swedish-born people was approximately double when compared to the one of people born outside the country.…”

Section: Limitations Of Frax and Available Adjustmentsmentioning

confidence: 99%

An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis

Schini,

Johansson,

Harvey

et al. 2023

J Endocrinol Invest

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FRAX®, a simple-to-use fracture risk calculator, was first released in 2008 and since then has been used increasingly worldwide. By calculating the 10-year probabilities of a major osteoporotic fracture and hip fracture, it assists clinicians when deciding whether further investigation, for example a bone mineral density measurement (BMD), and/or treatment is needed to prevent future fractures. In this review, we explore the literature around osteoporosis and how FRAX has changed its management. We present the characteristics of this tool and describe the use of thresholds (diagnostic and therapeutic). We also present arguments as to why screening with FRAX should be considered. FRAX has several limitations which are described in this review. This review coincides with the release of a version, FRAXplus, which addresses some of these limitations.

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“…The Fracture Risk Assessment Tool (FRAX) ( 167 ) helps predict the 10-year probability of hip fractures and major osteoporosis-related fractures, and has been used in several large studies exploring osteoporosis and fracture risks in the population ( 156 ). FRAX tool may require adjustment to have PD as an independent risk factor for fractures and as such, requires a modern adaptation to PwP ( 168 , 169 ).…”

Section: Dashboard Vitals: Bone Health and Fallsmentioning

confidence: 99%

Chaudhuri’s Dashboard of Vitals in Parkinson’s syndrome: an unmet need underpinned by real life clinical tests

Qamar,

Rota,

Batzu

et al. 2023

Front. Neurol.

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We have recently published the notion of the “vitals” of Parkinson’s, a conglomeration of signs and symptoms, largely nonmotor, that must not be missed and yet often not considered in neurological consultations, with considerable societal and personal detrimental consequences. This “dashboard,” termed the Chaudhuri’s vitals of Parkinson’s, are summarized as 5 key vital symptoms or signs and comprise of (a) motor, (b) nonmotor, (c) visual, gut, and oral health, (d) bone health and falls, and finally (e) comorbidities, comedication, and dopamine agonist side effects, such as impulse control disorders. Additionally, not addressing the vitals also may reflect inadequate management strategies, leading to worsening quality of life and diminished wellness, a new concept for people with Parkinson’s. In this paper, we discuss possible, simple to use, and clinically relevant tests that can be used to monitor the status of these vitals, so that these can be incorporated into clinical practice. We also use the term Parkinson’s syndrome to describe Parkinson’s disease, as the term “disease” is now abandoned in many countries, such as the U.K., reflecting the heterogeneity of Parkinson’s, which is now considered by many as a syndrome.

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Increased fracture risk in Parkinson's disease – An exploration of mechanisms and consequences for fracture prediction with FRAX

Cited by 4 publications

References 25 publications

Osteoporosis in Parkinson’s disease and the role of lean body mass: a cross-sectional study in a Brazilian tertiary center

Osteoporosis in Parkinson’s disease and the role of lean body mass: a cross-sectional study in a Brazilian tertiary center

An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis

Chaudhuri’s Dashboard of Vitals in Parkinson’s syndrome: an unmet need underpinned by real life clinical tests

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