title: Association between Parkinson's disease and low bone density and falls in older men: the osteoporotic fractures in men study.
abstract: OBJECTIVE
  To examine the association between Parkinson's disease (PD) and bone mineral density (BMD) and risk of falls.
  
  
  METHODS
  Cross-sectional and prospective cohort study.
  
  
  METHODS
  Six U.S. clinical centers.
  
  
  METHODS
  Five thousand nine hundred ninety-five community-dwelling, ambulatory men aged 65 and older.
  
  
  METHODS
  History of physician-diagnosed PD was ascertained from participant self-report. BMD was measured at the hip and spine using dual energy x-ray absorptiometry (DEXA) and quantitative computed tomography (QCT). Incident falls were ascertained for 1 year using mailed queries.
  
  
  RESULTS
  Fifty-two participants (0.9%) reported a history of PD. In multivariate models, PD was associated with significantly lower BMD at the spine (-4.9%, P=.04) and total hip (-5.3%, P=.007) using DEXA and at the spine (-6.7%, P=.05) and total hip (-8.2%, P=.03) using QCT. PD was associated with a nearly three times greater age-adjusted risk of multiple future falls (odds ratio (OR)=2.91, 95% confidence interval (CI)=1.55-5.46). Further adjustment for history of multiple falls in the year before baseline attenuated this risk, but it remained significant (OR=2.30, 95% CI=1.15-4.59).
  
  
  CONCLUSIONS
  In this cohort of older men, PD was associated with lower BMD at the hip and spine, measured using areal and volumetric BMD, as well as increased falls. Clinicians should consider screening older men with PD for osteoporosis.
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA. howard.fink@med.va.gov
authors.forename: Howard A
authors.initials: HA
authors.lastname: Fink
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kuskowski
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orwoll
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
mesh_terms: D015502:Absorptiometry, Photon; D000058:Accidental Falls; D000368:Aged; D015519:Bone Density; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000150:complications; D010300:Parkinson Disease / Q000150:complications; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed