Assessment and management of fracture risk in patients with Parkinson's disease
| Autor: | Veronica Lyell, Celia L Gregson, Mark Devine, Emily J. Henderson |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Aging
medicine.medical_specialty FRAX Movement disorders Parkinson's disease Osteoporosis Disease Risk Assessment Bone Density Risk Factors Vitamin D and neurology Medicine Humans In patient Vitamin D Intensive care medicine Aged Aged 80 and over Hip fracture Bone Density Conservation Agents business.industry Hip Fractures Age Factors Parkinson Disease General Medicine Middle Aged medicine.disease Vitamin D Deficiency Treatment Outcome Dietary Supplements Practice Guidelines as Topic Critical Pathways Accidental Falls Calcium Geriatrics and Gerontology medicine.symptom business Algorithms Osteoporotic Fractures |
| Zdroj: | Age and ageing. 44(1) |
| ISSN: | 1468-2834 |
| Popis: | Parkinson's disease (PD) is associated with substantially increased fracture risk, particularly hip fracture, which can occur relatively early in the course of PD. Despite this, current national clinical guidelines for PD fail to adequately address fracture risk assessment or the management of bone health. We appraise the evidence supporting bone health management in PD and propose a PD-specific algorithm for the fracture risk assessment and the management of bone health in patients with PD and related movement disorders. The algorithm considers (i) calcium and vitamin D replacement and maintenance, (ii) quantification of prior falls and fractures, (iii) calculation of 10-year major osteoporotic and hip fracture risks using Qfracture, (iv) application of fracture risk thresholds, which if fracture risk is high (v) prompts anti-resorptive treatment, with or without dual X-ray absorptiometry, and if low (vi) prompts re-assessment with FRAX and application of National Osteoporosis Guidelines Group (NOGG) guidance. A range of anti-resorptive agents are now available to treat osteoporosis; we review their use from the specific perspective of a clinician managing a patient population with PD. In conclusion, our current evidence base supports updating of guidelines globally concerning the management of PD, which presently fail to adequately address bone health. |
| Databáze: | OpenAIRE |
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