Session Information
Date: Tuesday, November 12, 2019
Title: Osteoporosis & Metabolic Bone Disease – Basic & Clinical Science Poster
Session Type: Poster Session (Tuesday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Parkinson’s disease is a common neurodegenerative disorder in older adults. Parkinson’s patients have an increase risk of falls. More over, previous studies have shown a reduced bone mineral density related to multifactorial factors. A meta-analysis performed in 2014 suggested an increased risk of fracture in Parkinson’s disease. The aim of this study is to update this previous meta-analysis to evaluate the association between Parkinson’s disease and fracture’s risk.
Methods: Eligible studies were search on PubMed, and Embase databases up to February, 2, 2019. Cohort studies, controlled or not, were selected. For each study, the authors extracted the risk of fracture for each anatomic site, or estimated it based on sample size and number of patients with fracture. Single risk ratios were then pooled to estimate a global risk ratio of fracture within a meta-analysis procedure using the inverse variance approach. Heterogeneity analysis was also performed with Cochran’s Q-test and I2value. RevMan software was used and p-value less than 5% was defined as significant.
Results: We included 13 retrospectives and propsectives cohort studies from the litterature’s review. They involved 975646 participants. Parkinson’s disease patients showed an increase fracture risk (RR globales fractures 2,09 (1,69-2,58)95% ; I2=95%). Especially hip fracture seems to be more frequent in Parkinson’s disease population (RR hip fracture 3,13 (2,36-3,15)95% ; I2=68%). A sensitivity analysis was performed, excluding the study of Paul et al. which enrolled exclusively patients having fallen. This sub-analysis confirmed the increase of hip fracture risk with a negligible level of heterogeneity (RR 2.49 (2.45-2.97) IC95% ; I2=0%).
Conclusion: Our results confirmed the previous meta-analysis of an increased risk of fracture in Parkinson’s disease, especially hip fracture recognized as a severe fracture associated with an increased morbidity and mortality. Currently, assessment of fracture’s risk is not included in guidelines for Parkinson’s disease patients care. Taking into account the increase risk of fracture, fracture’s risk assessment should be recommended in Parkinson’s disease adults.
hip fracture’s risk
The diamond represents the pooled RR and, the squares and the horizontal lines respectively represent the RR and 95% CI of each individual study.
sensitivity analysis hip’s fractures
The diamond represents the pooled RR and, the squares and the horizontal lines respectively represent the RR and 95% CI of each individual study.
total fracture’s risk
The diamond represents the pooled RR and, the squares and the horizontal lines respectively represent the RR and 95% CI of each individual study.
To cite this abstract in AMA style:
louvois m, Ferrero s, Barnetche T, roux c, Breuil V. Parkinson’s Disease and Risk of Fractures : A Meta Analysis of Cohort Studies [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/parkinsons-disease-and-risk-of-fractures-a-meta-analysis-of-cohort-studies/. Accessed .« Back to 2019 ACR/ARP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/parkinsons-disease-and-risk-of-fractures-a-meta-analysis-of-cohort-studies/