If you have Parkinson's Disease (PD) are you more likely to break your hip when you fall than other people?  A study done in a rehab hospital in Italy suggests yes…depending on your age.

Out of 877 patients who were admitted for a broken hip (hip fracture) that occurred from a fall, 28 patients with documented PD were compared to 28 patients who had no diagnosed neurological disorders.  The study matched the PD patients and the non-PD patients (control group) for age, sex, body size (BMI), and location of the broken bone (which part of the hip/femur). All patients in both groups were non-smokers. Bone density (BMD determined by DEXA scan) was measured in the non-broken on each of the patients in both groups.

The study found that bone density of the patients with PD did not differ significantly from the patients without PD if compared to a young, same-sex population.  However, the bone density of the PD patients was significantly lower when matched with the general population of the same sex and age.

Limitations of this study include the fact that it was done only on white patients (there are very few non-white elderly people living in Italy).  Bone density is influenced by race.  Additionally, levodopa (medication used to treat PD) may indirectly influence bone density; this was not included in the study.  The authors of the study did try to factor in the stages of PD (Hoehn & Yahr stage 1-mild to 5-severe) realizing that inactivity causes osteoporosis (loss of bone density).  The more severe stages of PD lead to less ability to be active.  The study did not include the relationship between low vitamin D and K seen in PD patients.  This is  thought to be a risk factor in low bone density and in fracture recovery.

Bottom line: The risk of breaking your hip if you fall and you have PD is much higher than if you didn't have PD.  Whether or not the cause is the PD itself or other associated risk factors remains to be seen. However, anyone who suffers from PD knows that they are at higher risk for falling, especially backwards or sideways: the posture, instability, slow muscle movement, tremors, inability to use their arms to stabilize themselves, rigidity, and sometimes blood pressure drops all make it very difficult to walk safely.

However, the medications used for PD and programs that your physician, physical therapist, and occupational therapist prescribe for you can help make your daily activities safer. Good reason to discuss this issue with your medical team.

For further information: "Bone mineral density in hip-fracture patients with Parkinson's disease: A case-control study," M. DiMonaco, F. Vallero, R. DiMonaco, R. Tappero, A. Cavanna, Archives of Physical Medicine and Rehabiliation, volume 87, issue 11, p. 1459-1462, November 2006.