Assessing and managing bone health and fracture risk in Parkinson's disease: the BONE PARK 2 protocol.
Background In Parkinson's disease (PD), the propensity to fall and the higher risk of osteoporosis converge yielding a high fracture risk. Updated National Osteoporosis Guideline Group (NOGG) guidance recommends that PD should trigger a risk assessment, for example using the FRAX tool, yet clinical...
| Publicado en: | Age & Ageing Vol. 54; no. 3; pp. 1 - 11 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Mar2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=184349363&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 184349363 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Mar2025 vid: 54 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 184349363 10.1093/ageing/afaf052 ppf: 1 ppct: 10 formats: tig: atl: Assessing and managing bone health and fracture risk in Parkinson's disease: the BONE PARK 2 protocol. aug: au: Naylor, Katie C on, Emma Tenis Hardcastle, Sarah A Lyell, Veronica Gregson, Celia L Henderson, Emily J affil: Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK Older People's Unit, Royal United Hospitals Bath NHS Foundation Trust, Bath, BA1 3NG, UK Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, BA1 3NG, UK Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, BS10 5NB, UK su: Cross-sectional method Disease risk factors Risk assessment Photon absorptiometry Research funding Bone density Parkinson's disease Descriptive statistics Bone fractures Femur neck Osteoporosis Accidental falls Disease complications sug: subj: Cross-sectional method Disease risk factors Risk assessment Photon absorptiometry Research funding Bone density Parkinson's disease Descriptive statistics Bone fractures Femur neck Osteoporosis Accidental falls Disease complications keyword: accidental falls bone mineral density fracture fractures guidelines hip fractures older people osteoporosis osteoporotic fracture risk osteoporotic fractures Parkinson disease recurrent falls world health organization frax osteoporotic fracture probability assessment tool accidental falls bone mineral density fracture fractures guidelines hip fractures older people osteoporosis osteoporotic fracture risk osteoporotic fractures Parkinson disease recurrent falls world health organization frax osteoporotic fracture probability assessment tool ab: Background In Parkinson's disease (PD), the propensity to fall and the higher risk of osteoporosis converge yielding a high fracture risk. Updated National Osteoporosis Guideline Group (NOGG) guidance recommends that PD should trigger a risk assessment, for example using the FRAX tool, yet clinical pathways remain sub-optimal. To address this, we generated an algorithm for the assessment and management of bone health specifically in PD. Methods Within the Proactive and Integrated Management and Empowerment in Parkinson's Disease randomised controlled trial (PRIME-UK RCT), bone-health metrics were collected, and all participants were offered a dual X-ray absorptiometry scan. The FRAX tool was used to obtain the 10-year probability of hip and major osteoporotic fracture (MOF), and the resulting NOGG risk-category recorded. Probabilities were recalculated including femoral-neck bone mineral density (FN-BMD) and/or with numeric adjustment for recurrent falls, and results compared. Results Among 182 people with parkinsonism (mean age 73.8 years, 65% male, median disease duration 5 years), 28% reported a prior fragility fracture, and 40.7% recurrent falls over the previous year. 28.6% had MOF above NOGG intervention thresholds (IT); whilst 12.1% had a FN-BMD T-Score ≤ −2.5. Recalculation of FRAX with FN-BMD (n = 182) reduced fracture MOF and hip fracture probabilities; 12 (6.6%) deescalated below the IT, and 16 (8.8%) moved above the IT. Conclusions This 2024 BONE-PARK algorithm is informed by both the latest NOGG Guidelines and novel findings in a 'real-world' population. The algorithm will aid bone health assessment for people with PD. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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