Objective: To assess the management of osteoporotic fragility fractures in patients with PD attending a Movement disorders clinic.

Background: Patients with PD have a high incidence of falls and are prone to sustaining osteoporotic fragility fractures. The results from the 2015 audit conducted by UK Parkinson’s Excellence Network have highlighted ‘poor management of bone health’ as only 36.4% were assessed for fracture risk.

Methods: Idiopathic PD patients attending the clinic over a 6 month period in 2016 were identified using an electronic patients recording system. Data was collected using a structured proforma, recording falls, fragility fractures and bone health treatment.

Results: 142 patients attended clinic. 103 patients were included in the study. Exclusions were due to other causes of Parkinsonism and two attendances in 6 months.

[Table 1]

The incidence of falls was similar in both genders whilst the fragility fractures were higher in females probably due to underlying osteoporosis. In this cohort; Hip fractures were the commonest fragility fractures followed by vertebral and wrist respectively. More than half the patients were taking bisphosphonates.

Conclusions: PD patients are at high risk of falling and sustaining fragility fractures. Physicians should actively seek history regarding such fractures and their management. Patient education regarding bisphosphonate should be done routinely to improve compliance especially in patients with cognitive impairment and/or swallowing problems. Parenteral antiresorptive therapy is an alternative option including a period for ‘drug holiday ‘ after 3 -5 years.

References: 1. Torsney KM, Noyce AJ, Doherty KM, Bestwick RD, Lees AJ. Bone health in Parkinson’s disease: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2013-307307

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MDS Abstracts - https://www.mdsabstracts.org/abstract/management-of-fragility-fractures-in-parkinsons-disease-pd/