Bone and mineral metabolism in older adults with Parkinson's disease

Abstract

Objectives: Parkinson's disease (PD) and osteoporosis are two common chronic disabling conditions in older adults that adversely affect quality of life. The aim of the present work was to study the relationship between bone changes and PD. Methods: eighty-two patients with established PD aged 65 years or older and 68 age-, sex- and body mass index (BMI)-matched healthy control subjects were recruited. Exclusion criteria included other known causes of osteoporosis. Data including BMI, sunlight exposure, Hoehn and Yahr stage, disease duration and history of previous falls and/or fractures were collected. Bone mineral density was measured using dual energy x-ray absorptiometry. Sera were analysed for ionised calcium, vitamin D, bone alkaline phosphatase (BALP) and urinary N-terminal telopeptide of type I collagen (NTx). Physical and mental performance was also assessed. Results: the findings show that the bone mineral density (BMD) of all PD patients was significantly lower compared to controls. PD patients had significantly decreased vitamin D levels, significantly increased BALP and NTx levels, reduced physical and mental performance and more falls and/or fractures in comparison to healthy controls. Conclusion: PD is associated with an increased incidence of osteoporosis, falls and fractures. PD is thus a risk factor for osteoporosis and appropriate therapeutic interventions should be initiated to slow or prevent disability. © The Author 2009. Published by Oxford University Press [on behalf of the British Geriatrics Society]. All rights reserved.