title: Risk of fracture in patients with Parkinson's disease.
abstract: The aim of the study was to determine fracture risk in incident Parkinson's disease (PD) patients. This study showed that fracture risk assessment may be indicated among patients with PD, in particular when they have recently used selective serotonin re-uptake inhibitors or high-dose antipsychotics, or have a history of fracture, falling, low body mass index (BMI) or renal disease.
  
  
  BACKGROUND
  PD is a movement disorder associated with falling and detrimental effects on bone. Both are recognized risk factors for fracture. Therefore, the aim was to determine fracture risk in incident PD patients stratified by treatment, severity, duration of disease and related comorbidities.
  
  
  METHODS
  We conducted a retrospective cohort study using the UK General Practice Research Database (1987-2011). Each PD patient was matched by age, sex, calendar time and practice to a control patient without history of PD.
  
  
  RESULTS
  We identified 4,687 incident PD patients. Compared to controls, a statistically significant increased risk was observed for any fracture (adjusted hazard ratio [AHR], 1.89; 95 % confidence interval [CI], 1.67-2.14), osteoporotic fracture (AHR, 1.99; 95 % CI, 1.72-2.30) and hip fracture (AHR 3.08; 95 % CI, 2.43-3.89). Fracture risk further increased with history of fracture, falling, low BMI, renal disease, antidepressant use and use of high-dose antipsychotics.
  
  
  CONCLUSIONS
  This study showed that incident PD patients have a statistically significant increased risk of fracture. Therefore, fracture risk assessment may be indicated among PD patients, who, besides the general risk factors for fracture, like increasing age and female gender, have recently used selective serotonin re-uptake inhibitors or high-dose antipsychotics or have a history of fracture, falling, low BMI or renal disease.
authors: Utrecht Institute for Pharmaceutical Sciences, Universiteit Utrecht, Universiteitsweg, 99, 3584 CG Utrecht, Netherlands.
authors: S
authors: S
authors: Pouwels
authors: M T
authors: MT
authors: Bazelier
authors: A
authors: A
authors: de Boer
authors: W E J
authors: WE
authors: Weber
authors: C
authors: C
authors: Neef
authors: C
authors: C
authors: Cooper
authors: F
authors: F
authors: de Vries
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors