Association Between Parkinson's Disease and Low Bone Density and Falls in Older Men: The Osteoporotic Fractures in Men Study

Authors

  • Howard A. Fink MD, MPH,

    1. From the *Geriatric Research Education and Clinical CenterCenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MinnesotaDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota§Department of Medicine, Oregon Health Sciences University, Portland, OregonDivision of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • Michael A. Kuskowski PhD,

    1. From the *Geriatric Research Education and Clinical CenterCenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MinnesotaDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota§Department of Medicine, Oregon Health Sciences University, Portland, OregonDivision of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • Eric S. Orwoll MD,

    1. From the *Geriatric Research Education and Clinical CenterCenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MinnesotaDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota§Department of Medicine, Oregon Health Sciences University, Portland, OregonDivision of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • Jane A. Cauley DrPH,

    1. From the *Geriatric Research Education and Clinical CenterCenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MinnesotaDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota§Department of Medicine, Oregon Health Sciences University, Portland, OregonDivision of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • Kristine E. Ensrud MD, MPH,

    1. From the *Geriatric Research Education and Clinical CenterCenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MinnesotaDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota§Department of Medicine, Oregon Health Sciences University, Portland, OregonDivision of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • for the Osteoporotic Fractures in Men (MrOS) Study Group

    1. From the *Geriatric Research Education and Clinical CenterCenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MinnesotaDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota§Department of Medicine, Oregon Health Sciences University, Portland, OregonDivision of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute on Aging, and the National Cancer Institute provided funding under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, and M01 RR000334.

  • A portion of the data in this manuscript was presented as a poster at the 2001 meeting of the American Society of Bone and Mineral Research.

Address correspondence to Howard A. Fink, MD, MPH, VA Medical Center, One Veterans Drive, Box 11G, Minneapolis, MN 55417. E-mail: howard.fink@med.va.gov

Abstract

Objectives: To examine the association between Parkinson's disease (PD) and bone mineral density (BMD) and risk of falls.

Design: Cross-sectional and prospective cohort study.

Setting: Six U.S. clinical centers.

Participants: Five thousand nine hundred ninety-five community-dwelling, ambulatory men aged 65 and older.

Measurements: History of physician-diagnosed PD was ascertained from participant self-report. BMD was measured at the hip and spine using dual energy x-ray absorptiometry (DEXA) and quantitative computed tomography (QCT). Incident falls were ascertained for 1 year using mailed queries.

Results: Fifty-two participants (0.9%) reported a history of PD. In multivariate models, PD was associated with significantly lower BMD at the spine (−4.9%, P=.04) and total hip (−5.3%, P=.007) using DEXA and at the spine (−6.7%, P=.05) and total hip (−8.2%, P=.03) using QCT. PD was associated with a nearly three times greater age-adjusted risk of multiple future falls (odds ratio (OR)=2.91, 95% confidence interval (CI)=1.55–5.46). Further adjustment for history of multiple falls in the year before baseline attenuated this risk, but it remained significant (OR=2.30, 95% CI=1.15–4.59).

Conclusion: In this cohort of older men, PD was associated with lower BMD at the hip and spine, measured using areal and volumetric BMD, as well as increased falls. Clinicians should consider screening older men with PD for osteoporosis.

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