Objective: The objective of this study is to estimate the incidence of fragility fractures in people with Parkinson’s (PwP) over a 5 year period and to evaluate the impact on patient outcome.

Background: People with Parkinson’s [PwP] are at high risk of falls with adverse clinical outcomes including fragility fracture. There is an increased risk of osteoporosis in PwP and multiple assessment tools exist for risk stratification, yet fragility fractures and osteoporosis remain under- diagnosed in PwP. The incidence and prevalence of fragility fractures are under-recognised.¹²

Methods: This retrospective service evaluation is based on the existing data for people attending Parkinson’s clinics in 3 hospitals in South Wales, UK. Demographics, phenotype, H&Y score, frailty score, medications and fracture events were extracted from electronic health records system.

Results: 115 PwP [mean age 71, Females 51%] from 3 different centres were studied. 84.5% IPD with predominant phenotype being akinetic-rigid [64.5%]. On diagnosis, their mean Hoehn & Yahr score [H&Y], Clinical Frailty Score [CFS] and average number of drugs were 1.76[1-5], 3.42[1-7] & 4.75 [0-13] respectively. Over a five year period, there were 30 episodes of fragility fractures with an incidence of 26% and 23% of fractures were second events. Mean latency from diagnosis to first fracture was 2.5 years [0-5]. The fracture profile were: Vertebral- 36.5% [11/30], Hip- 26.5% [8/30], Wrist- 16.5% [5/30], Pelvic- 6% [2/30], Others- 13% [4/30]. The fracture cohort revealed an increased risk of institutionalisation and a higher need for formal social support [39% &94% respectively] compared with the non-fracture cohort [32% &46% respectively]. 77% of patients who fractured showed akinetic-rigid phenotype.

Conclusions: Incidence of fragility fractures is significant in PwP and more common in akinetic-rigid phenotype. Fragility fractures appear to result in higher institutionalisation rate and greater levels of community social care. This stresses the need for prompt evaluation of osteoporosis risk and timely management. Even though disease severity, frailty and medication burden are higher in PwP who suffer fractures, the association is not significant. We acknowledge the low power of our study and recommend larger studies to better demonstrate the association. References: 1. Dennison et al. Bone 2012;50:1288-93. 2. Genever et al. Age Ageing 2005;34:21-4.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/incidence-of-fragility-fractures-in-people-with-parkinsonism-pwp-a-5-year-retrospective-observational-study/