Parkinson disease and metabolic bone disorders: A common connection that needs more attention

摘要

The Department of Neurology at the Boston Medical Center (Boston, Massachusetts) has had a long-standing interest in Parkinson disease (PD), which has given members of the Endocrine Section the opportunity to participate in the care of affected patients, particularly those who have fallen and sustained fractures. Patients with PD present with a long list of problems, which lengthens as the disease progresses. Cardinal features include rigidity, tremor, bra-dykinesia, postural unsteadiness, and orthostatic hypotension (1). Each of these abnormalities contributes to falls, and 5% to 6% of falls result in fractures in persons beyond the age of 60 years-the age at which the incidence of PD increases sharply (2). In a meta-analysis of 6 prospective studies of falling in 473 patients with PD, the 3-month rate of falling was 46%, and the strongest predictor of falling was a history of 2 or more falls during the prior year (3).