Objective: To assess the impact of, and practicality of, assessing bone health routinely in people newly diagnosed with Parkinson’s disease in a South Wales University Hospital Parkinson’s service

Background: People with Parkinson’s (PWP) are at an increased risk of fracture through their increased risk of both osteoporosis and falls.  It follows that after a fracture, the risk of further falls and the need for institutional care are increased.  This negatively impacts on quality of life, morbidity and has significant economic burden.  In recent years new tools have emerged for risk-stratification of osteoporosis in Parkinson’s along with recommendations for management of bone health.

Methods: Using our clinical patient record and database, we compared two sample cohorts of PWP – those diagnosed in 2010 (n=30) and those diagnosed in 2016 (n=20).  We examined whether bone health had been assessed and recorded any subsequent fracture incidences. We applied risk stratification to the 2016 cohort to assess for “gold standard” treatment using the available tools (Qfracture, FRAX).  In a separate study, we examined the practicality of using these tools within the framework of the busy Parkinson’s clinic setting

Results: None of the 2010 cohort had any documentation of specific screening or risk stratification of bone health. In the 2016 cohort, all patients were eligible for further investigation (DEXA) or treatment (vitamin D or anti-resorptives) on the basis of their QFracture or FRAX scores.  PWP found the questionnaires in clinic quick and acceptable, and the time taken to complete the scores ranged from 1-3 minutes which the authors did not feel would add any significant burden to clinical time.

Conclusions: Bone health screening historically has been poor, and newer tools are now available for clinicians. Further study is needed to determine whether the FRAX and QFracture may be too sensitive as all patients diagnosed with PD were deemed eligible for bone health intervention – negating the need for the tools to be used.  However, the tools are acceptable and do not significantly prolong clinical consultations.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assessing-bone-health-in-parkinsons-when-and-how/