Background: Osteoporosis is 3 times more likely in patients with Parkinson's Disease (PD) compared to age matched controls due to a range of factors including immobility, decreased muscle strength and low body weight. Hyperhomocysteinaemia is an independent risk factor for osteoporosis and is common in PD secondary to levodopa use.
Innovation Assessment of osteoporosis risk can be made via the FRAX & NOGG or Q fracture methods but it is not yet clear which is the most accurate method for assessing risk in patients with PD.
Evaluation: All patients between 1/1/2011 to 31/12/2012 with a fractured neck of femur and Parkinson's Disease were identified (N = 24). 2 patients notes could not be located and one patient died within two weeks and thus were excluded from the study group (N = 21). Data was collected from the patient records. FRAX/NOGG and Q fracture risk assessment scores were calculated for each patient and comparison of the management advice suggested by each score was made.
There were 21 patients in total (7 male and 14 female). 13 had complex and 8 had maintenance stage Parkinson's Disease.
Conclusion: Q fracture risk assessment identified an additional 19% (N = 4) of patients with Parkinson's Disease who were at risk of osteoporotic fragility fracture in comparison to the use of the FRAX/NOGG assessment tool. 18 patients were not on any osteoporosis treatment pre-fracture suggesting there is a cohort of patients who might be at risk of osteoporosis who are not currently being adequately assessed and managed. Routine screening for osteoporosis should be undertaken in patients with Parkinson's Disease and this is best done with use of the Q fracture assessment tool.