Fracture incidence and osteoporosis treatment in Parkinson's disease: a population-based cohort study

Individuals with Parkinson's disease have an increased fracture risk. We found approximately 3% of individuals newly diagnosed with Parkinson's disease have a fragility fracture in the year following diagnosis, with low rates of screening and treatment for osteoporosis. Education is required to minimize this gap for an at-risk population.

Individuals with Parkinson's disease (PD) have an increased risk of fractures due to increased rates of falls and osteoporosis, yet bone health in PD is often overlooked. This study described fracture rates, use of osteoporosis medications, and bone mineral density (BMD) screening in individuals newly diagnosed with PD.

Administrative data were used to conduct a population-based cohort study in individuals over 65 years of age, with newly diagnosed PD in Ontario, Canada between January 2008 and December 2023. Descriptive statistics on rates of fracture, use of osteoporosis medication, and BMD testing within the year following diagnosis were reported overall and stratified by sex. Cox proportional hazard models were adjusted for age, sex, Charlson comorbidity score, previous diagnosis of osteoporosis, history of fragility fracture, and use of corticosteroids.

After exclusions, 28,119 individuals were included in our cohort, of whom 39.9% were female. Within 1 year of PD diagnosis, 3.1% experienced a fragility fracture (3.4 per 100 person-years), 17.6% received a prescription for an osteoporosis medication, and 9.8% received a BMD test. Rates for all outcomes were greater among females than males. In the adjusted analysis, higher fracture rates were observed in females, those aged ≥ 80 years, with prior fragility fractures, and higher comorbidity scores.

Despite elevated fracture risk, fewer than one in five individuals with PD received osteoporosis screening or treatment within a year of diagnosis. These findings highlight the need for proactive bone health strategies to prevent fragility fractures in this high-risk population.