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Association of Parkinson’s disease with accelerated bone loss, fractures and mortality in older men: the Osteoporotic Fractures in Men (MrOS) study

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Abstract

Summary

Among community-dwelling older men, compared to those without Parkinson’s disease (PD), over approximately 5 years, those with baseline PD had a significantly greater rate of annualized total hip bone loss (−1.1% vs. 0.4%), proportion of incident non-spine fractures (14.9% vs. 7.2%) and mortality (34.8% vs. 9.5%).

Introduction

The objective of this study was to examine the association of Parkinson’s disease (PD) with bone loss and fractures in older men.

Methods

This prospective cohort study analyzed data from 5,937 community dwelling men aged ≥65 years at six clinical centers of the Osteoporotic Fractures in Men (MrOS) Study. At baseline and visit two (mean interval 4.6 +/−0.4 SD years), community-diagnosed PD was ascertained by self-report and hip bone mineral density (BMD) was measured using dual energy x-ray absorptiometry (DXA). Incident fractures were self-reported. Fractures and deaths were centrally adjudicated.

Results

At baseline, 46 (0.8%) men had PD. Age-adjusted mean annualized total hip bone loss was greater in men with vs. those without PD (−1.08% vs. −0.36%, p < 0.001). 15.2% of men with PD and 7.2% of men without PD experienced an incident non-spine fracture (age-adjusted HR 2.4, 95%CI 1.1–5.0). 34.8% of men with PD and 9.5% of men without PD died during follow-up (age-adjusted HR 3.5, 95%CI 2.2–5.5). Associations of PD with bone loss, fractures and mortality were modestly altered by additional individual adjustment for possible confounders.

Conclusions

In community-dwelling older men, PD was associated with increased bone loss, fractures and mortality. In addition to implementing fall prevention measures, clinicians should consider osteoporosis screening in older men with PD.

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Potential financial conflicts of interest

Dr. Schousboe receives research grant support from Hologic, Inc. Dr. Ensrud receives research grant support from Bionovo. Dr. Orwoll receives research, consulting or speaking support from Aventis, Pfizer, Eli Lilly & Co., Novartis, Merck & Co., Procter & Gamble, GlaxoSmithKline, Zelos Therapeutics Inc., Imaging Therapeutics Ind., and Solvay Pharmaceuticals. All other authors have no conflicts of interest.

Author contributions

Conception and design: H.A. Fink, M.A. Kuskowski

Acquisition of participants and/or data: E.S. Orwoll, K.E. Ensrud

Analysis and interpretation of the data: H.A. Fink, M.A. Kuskowski, B.C. Taylor, J.T. Schousboe, K.E. Ensrud

Drafting of the article: H.A. Fink

Critical revision of the article for important intellectual content: H.A. Fink, M.A. Kuskowski, B.C. Taylor, J.T. Schousboe, E.S. Orwoll, K.E. Ensrud

Final approval of the article: H.A. Fink, M.A. Kuskowski, B.C. Taylor, J.T. Schousboe, E.S. Orwoll, K.E. Ensrud

Sponsor’s role

The funding agencies played no role in the design, analysis and preparation of this manuscript.

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Authors and Affiliations

  1. Geriatric Research Education and Clinical Center, VA Medical Center, Minneapolis, MN, USA

    H. A. Fink & M. A. Kuskowski

  2. Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, MN, USA

    H. A. Fink, B. C. Taylor & K. E. Ensrud

  3. Department of Medicine, University of Minnesota, Minneapolis, MN, USA

    H. A. Fink & K. E. Ensrud

  4. Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    H. A. Fink, B. C. Taylor & K. E. Ensrud

  5. Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    J. T. Schousboe

  6. Division of Rheumatology, Park Nicollet Health Services, Minneapolis, MN, USA

    J. T. Schousboe

  7. Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA

    E. S. Orwoll

  8. VA Medical Center, One Veterans Drive, Box 11G, Minneapolis, MN, 55417, USA

    H. A. Fink

Authors
  1. H. A. Fink
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  2. M. A. Kuskowski
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  3. B. C. Taylor
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  4. J. T. Schousboe
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  5. E. S. Orwoll
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  6. K. E. Ensrud
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for the Osteoporotic Fractures in Men (MrOS) Study Group

Corresponding author

Correspondence to H. A. Fink.

Additional information

Funding sources

The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR) and NIH Roadmap for Medical Research under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01-AG027810, and UL1 RR024140.

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Fink, H.A., Kuskowski, M.A., Taylor, B.C. et al. Association of Parkinson’s disease with accelerated bone loss, fractures and mortality in older men: the Osteoporotic Fractures in Men (MrOS) study. Osteoporos Int 19, 1277–1282 (2008). https://doi.org/10.1007/s00198-008-0584-4

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  • DOI: https://doi.org/10.1007/s00198-008-0584-4

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