title: Falls, fractures and bone density in Parkinson's disease - a cross-sectional study.
abstract: OBJECTIVE
  Evidence suggests that falls and associated bone fractures are more frequent in patients suffering from Parkinson's disease (PD) than in the general population. In this cross-sectional study we evaluated the clinical and biochemical characteristics that are associated to falls, fractures and bone health in a population of PD subjects.
  
  
  METHODS
  Forty-two consecutive subjects suffering from idiopathic PD (mild-to-moderate severity) with/without falls in the previous year were included. They were characterized as regards functional independence, balance, fear of falling, bone density (ultrasound densitometry) and plasma levels of vitamin D. Twenty-one age- and sex-matched healthy subjects were evaluated as controls.
  
  
  RESULTS
  We detected a greater degree of osteoporosis in PD subjects as compared to controls, more pronounced in males than in females (Z-score: M -3.8 ± 1.6, F -2.28 ± 0.92, p = 0.0006). A positive correlation was found between independence levels and bone density or vitamin D levels. Twenty seven patients (64%) reported falls in the previous year. These were associated to post-traumatic fractures in 16 subjects (59% of fallers). Women fell more than men (fallers: 20 F/7 M; non fallers: 4 F/11 M, χ² test p = 0.02), although the occurrence of post-traumatic fractures among fallers did not differ between sexes (F 11/9, M 5/2, χ² test p > 0.05). Fallers with post-traumatic fractures showed higher degrees of motor impairment.
  
  
  CONCLUSIONS
  These findings confirm that falls and osteoporosis represent major health issues in PD, already in the middle stages of disease.
authors.affiliation: a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.|b Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tassorelli
authors.affiliation: a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.|b Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Berlangieri
authors.affiliation: a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Buscone
authors.affiliation: a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Bolla
authors.affiliation: a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.|b Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: De Icco
authors.affiliation: c Department of Physical Medicine and Rehabilitation , University Hospital "Maggiore della Carità" , Novara , Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Baricich
authors.affiliation: a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pacchetti
authors.affiliation: c Department of Physical Medicine and Rehabilitation , University Hospital "Maggiore della Carità" , Novara , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cisari
authors.affiliation: a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.|b Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sandrini
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D003720:Densitometry; D005239:Fear / Q000523:psychology; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000523:psychology; D004856:Postural Balance / Q000502:physiology; D012678:Sensation Disorders / Q000209:etiology; D012720:Severity of Illness Index; D012737:Sex Factors; D014463:Ultrasonography; D014807:Vitamin D / Q000097:blood
chemical_list: D014807:Vitamin D
keywords: balance; bone density; falls; functional independence; gender; traumatic fractures