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Geriatrics 2017, 2(2), 17; doi:10.3390/geriatrics2020017

Fragility Fractures and Parkinsonism: Relationship of Fractures with Demography, Severity and Predictors of Adverse Outcomes

1
Department of Geriatric Medicine, Ysbyty Ystrad Fawr, Aneurin Bevan University Health Board, Wales CF82 7EP, UK
2
Geriatric Medicine, Aneurin Bevan University Health Board, Wales CF82 7EP, UK
3
Consultant Clinical Scientist, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport NP20 2UB, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Ralf Lobmann
Received: 23 March 2017 / Revised: 21 April 2017 / Accepted: 5 May 2017 / Published: 24 May 2017
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Abstract

Background: The risk of falls is higher in patients with Parkinsonism (PwP) as compared to other older adults, leading to adverse outcomes including fragility fractures. Osteoporosis is under-recognised and the current prevalence of fragility fractures is not well-studied. The objectives of this study are to determine the prevalence of fragility fractures in PwP, to measure the relationship of fractures with demography, severity and to measure predictors of adverse outcomes in this population. Method/Description: This was a retrospective observational cohort study based on the analysis of existing data for all the patients attending Caerphilly Movement Disorder Clinic. Information on demographics, the severity of Parkinsonism and fragility fractures was extracted electronically from the clinical workstation, clinic letters and coding from January 2015 to October 2016. Results: 397 people (mean age = 77.1 ± 9.4, 46% females) were studied. Of these, 77% (306/397) had Parkinsonism and 80% (244/306) had idiopathic Parkinson’s disease (PD). The mean Hoehn & Yahr Score at the time assessment was 3.09 ± 1.16. Additionally, 23.5% (72/306) were deemed to have osteoporosis based on the radiological evidence of fragility fractures. The PwP who sustained fractures were comparatively older (80.4 ± 12.1) and 70% (50/72) were females. The most common site for fractures was vertebral (47.2%; 34/72). Also, 22.2% of the sample (16/72) had suffered a fragility fracture before the diagnosis of PD. However, a majority (77.8%; 56/72) had sustained a fracture during the course of PD with a mean lapse of 6 years (range = 0–13 years) from initial diagnosis. Only 40% (29/72) of patients were prescribed osteoporosis drugs as per guidelines. There is a significant correlation of advancing age, severity and duration of PD with fragility fractures. The single best predictor of mortality is severity of PD, followed by age and fractures. Conclusions: There is a high prevalence of fragility fractures in patients attending movement disorder clinics, although 60% do not receive evidence-based medical treatment for the underlying osteoporosis. The prevalence of fragility fractures is positively correlated with the duration and severity of PD. We acknowledge the relatively small sample size as the study’s limitation. View Full-Text
Keywords: fragility fracture; osteoporosis; Parkinson’s disease; disease severity; disease duration fragility fracture; osteoporosis; Parkinson’s disease; disease severity; disease duration
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Aithal, S.; Sequeira, R.; Edwards, C.; Singh, I. Fragility Fractures and Parkinsonism: Relationship of Fractures with Demography, Severity and Predictors of Adverse Outcomes. Geriatrics 2017, 2, 17.

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