Low Bone Density in Older Men With Parkinson’s Disease

Fink HA, Kuskowski MA, Orwoll ES, et al, for the Osteoporotic Fractures in Men (MrOS) Study Group. Association between Parkinson's disease and low bone density and falls in older men: the Osteoporotic Fractures in Men Study. J Am Geriatr Soc.2005;53:1559-1564.

Increased incidence of falls and low bone mineral density (BMD) may increase the risk of fractures in elderly men with Parkinson's disease (PD), according to the results of a study by Fink et al. "Clinicians should consider screening older men with PD for osteoporosis and implementing measures to reduce falls," the authors say. Whether diet, exercise, or pharmacologic intervention may lower the risk in this patient population remains to be seen, they add.

The Osteoporotic Fractures in Men cohort comprised 5,995 community-dwelling men 65 or older (all but three were white) recruited from six US clinical sites. Exclusion criteria included inability to walk without assistance and history of bilateral hip replacement. Among the physical measurements taken at baseline were areal BMD of the lumbar spine, total hip, and hip subregions; study participants were also asked about prior diagnosis of PD, other medical history, and diet. During a year of follow-up, subjects were queried by mail every four months regarding incident falls.

Of the cohort, 52 subjects had a history of PD. Men with PD reported engaging in less physical activity and were more likely to have fallen in the year before baseline than men without PD. Men with PD also had relatively worse cognition, slower usual gait speed, worse leg power, and weaker grip.

After adjustment for age and independent of dietary vitamin D intake, men with PD had a 4.8% and 6.5% lower mean areal BMD at the spine and total hip, respectively, than men without PD--a statistically significant difference, the authors note. During the follow-up period, 28.6% of men with PD and only 11.7% of men without PD fell at least twice.