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 rehabilitation 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 Parkinson’s were compared to 28 patients who had no diagnosed neurological disorders.  The study matched the Parkinson’s patients and the non-Parkinson’s 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.

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

Parkinson’s Study Limitations
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 (Parkinson’s medication) may indirectly influence bone density; this was not included in the study.

The authors of the study did try to factor in Parkinson’s stage (Hoehn & Yahr stage 1-mild to 5-severe) realizing that inactivity causes osteoporosis (loss of bone density).  Parkinson’s stages that are more severe lead to less ability to be active.  The study did not include the relationship between low vitamin D and K seen in Parkinson’s patients.  This is thought to be a risk factor in low bone density and in fracture recovery.

Parkinson’s Risk Factors Play a Part
Bottom line: The risk of breaking your hip if you fall and you have Parkinson’s is much higher than if you didn't have Parkinson’s.  Whether or not the cause is the Parkinson’s itself or other associated risk factors remains to be seen. However, anyone who suffers from Parkinson’s 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 Parkinson’s medications and programs that your physician, physical therapist, and occupational therapist prescribe for you can help make your activities of daily living. Discuss this issue with your medical team for more information specific to your diagnosis.

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.

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