Association between Parkinson's disease and low bone density and falls in older men: The Osteoporotic Fractures in Men study

OBJECTIVES: To examine the association between Parkinson's disease (PD) and bone mineral density (BMD) and risk of falls. DESIGN: Cross-sectional and prospective cohort study. SETTING: Six U. S. clinical centers. PARTICIPANTS: Five thousand nine hundred ninety-five community-dwelling, ambulatory men aged 65 and older. MEASUREMENTS: History of physician-diagnosed PD was ascertained from participant self-report. BMD was measured at the hip and spine using dual energy x-ray absorptiometry ( DEXA) and quantitative computed tomography (QCT). Incident falls were ascertained for 1 year using mailed queries. RESULTS: Fifty-two participants (0.9%) reported a history of PD. In multivariate models, PD was associated with significantly lower BMD at the spine (-4.9%, P = .04) and total hip (-5.3%, P = .007) using DEXA and at the spine (-6.7%, P = .05) and total hip (-8.2%, P = .03) using QCT. PD was associated with a nearly three times greater age-adjusted risk of multiple future falls (odds ratio (OR) = 2.91, 95% confidence interval (CI) = 1.55-5.46). Further adjustment for history of multiple falls in the year before baseline attenuated this risk, but it remained significant (OR = 2.30, 95% CI = 1.15-4.59). CONCLUSION: In this cohort of older men, PD was associated with lower BMD at the hip and spine, measured using a real and volumetric BMD, as well as increased falls. Clinicians should consider screening older men with PD for osteoporosis.