Risk and adverse outcomes of fractures in patients with Parkinson’s disease: two nationwide studies

Huang, Yu Feng; Cherng, Yih-Giun; Hsu, Sanford P.C.; Yeh, Chun Chieh; Chou, Yueh Ching; Wu, Chun-Hsin; Chen, Ta-Liang; Liao, Chien-Chang

doi:10.1007/s00198-015-3052-y

Cited by 33 publications

(33 citation statements)

References 44 publications

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“…Interestingly, in this study, the relative risk of falls and fractures between male PD subjects and male non-PD comparators (IRR, 2.23; 95% CI, 1.93–2.59) was more pronounced than that between female PD subjects and female non-PD comparators (IRR, 1.96; 95% CI, 1.75–2.18). Similar results also were observed in previous studies [6,15,16]. The excess relative risk in male PD compared with female PD subjects has not been assessed in previous studies, and consequently has previously received little attention.…”

Section: Discussionsupporting

confidence: 89%

“…In the non-PD cohort, the risk of falls and fractures was relatively stable before 65 years of age, but doubled after 65 years of age, whereas in PD patients the risk rose steadily from 40 years of age. This difference has also been observed in previous studies [6], and indicates that factors intrinsic to PD such as disease severity and functional impairment might be more important determinants of the risk of falls and fractures in PD patients.…”

Section: Discussionsupporting

confidence: 79%

“…In a large nationwide population-based claims study of people aged 40 years and older living in Taiwan, the estimate of the risk for fractures in PD patients was slightly higher (adjusted hazard ratio, 2.25; 95% CI, 1.97–2.58) [6]. A meta-analysis using pooled data from 9 studies also reported a slightly higher risk in PD patients compared with non-PD patients (odds ratio, 2.28; 95% CI, 1.83–2.83) than what we have found [4].…”

Section: Discussionmentioning

confidence: 99%

“…[5] Falls and fractures may result in a series of unfavorable outcomes, such as disabilities and death. [6] Furthermore, among PD patients with fractures, the mortality rate is approximately 10.6% [6]. …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…The efficacy of bisphosphonates against hip fracture has been shown for Parkinson’s disease patients. (47) …”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS)

Cauley

Cawthon

Peters

et al. 2016

Journal of Bone and Mineral Research

120

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Almost 30% of hip fractures occur in men; the mortality, morbidity, and loss of independence after hip fractures are greater in men than in women. To comprehensively evaluate risk factors for hip fracture in older men, we performed a prospective study of 5994 men, primarily white, age 65+ years recruited at six US clinical centers. During a mean of 8.6 years of 97% complete follow-up, 178 men experienced incident hip fractures. Information on risk factors including femoral neck bone mineral density (FNBMD) was obtained at the baseline visit. Cox proportional hazards models were used to calculate the hazard ratio (HR) with 95% confidence intervals; Fine and Gray models adjusted for competing mortality risk. Older age (≥75 years), low FNBMD, currently smoking, greater height and height loss since age 25 years, history of fracture, use of tricyclic antidepressants, history of myocardial infarction or angina, hyperthyroidism or Parkinson’s disease, lower protein intake, and lower executive function were all associated with an increased hip fracture risk. Further adjustment for competing mortality attenuated HR for smoking, hyperthyroidism, and Parkinson’s disease. The incidence rate of hip fracture per 1000 person-years (PY) was greatest in men with FNBMD T-scores <−2.5 (white women reference database) who also had 4+ risk factors, 33.4. Men age ≥80 years with 3+ major comorbidities experienced hip fracture at rates of 14.52 versus 0.88 per 1000 PY in men age <70 years with zero comorbidities. Older men with low FNBMD, multiple risk factors, and multimorbidity have a high risk of hip fracture. Many of these assessments can easily be incorporated into routine clinical practice and may lead to improved risk stratification.

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Back Injuries and Management of low Back Pain in Basketball

Massie

Buell

Behrbalk

et al. 2020

Basketball Sports Medicine and Science

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Risk and adverse outcomes of fractures in patients with Parkinson’s disease: two nationwide studies

Abstract: PD was associated with higher risk of fracture. Patients with PD had more complications and mortality after fracture. Fracture prevention and attention to post-fracture adverse events are needed for this susceptible population.

Cited by 33 publications

References 44 publications

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

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

Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS)

Back Injuries and Management of low Back Pain in Basketball

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