Risk Factors for Vertebral, Hip, and Femoral Fractures Among Patients With Parkinson's Disease

A 5-Year Follow-up in Korea

Sung Bae Park, Chun Kee Chung, Jee Young Lee, Jinyong Lee, Jayeun Kim

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: To investigate the prevalence and incidence of Parkinson's disease (PD)and provide evidence for preventive strategy of vertebral, hip, and femoral fractures (VF, HF, and FF)in PD patients. Design: Retrospective cohort study. Setting and Participants: Using a nationwide medical service utility database from 2009 to 2014, we enrolled PD patients with diagnosis of G20 as per ICD-10 who used medical services. Overall, the number of PD patients was 97,311, 106,072, 115,762, 127,647, 137,782, and 144,757 through 2009-2014, respectively. We followed 35,663 patients diagnosed with PD in 2010 without prior fracture. Measures: We estimated the annual PD prevalence and incidence and used Cox proportional hazards model to estimate the hazards ratio (HR)for factures based on demographic characteristics, underlying disease, and socioeconomic status according to fracture type (osteoporosis-related fracture, VF, HF/FF). Furthermore, we investigated the cumulative incidence of those fractures by month during the 5-year follow-up. Results: The standardized PD prevalence increased from 238 to 279 between 2009 and 2014, and its incidence decreased from 86 to 72 between 2010 and 2014 per 100,000 population based on 2015 census data. We followed 35,663 PD patients: women, 20,732 (58.1%); aged ≥60 years, 29,264 (82.1%); with osteoporosis, 6542 (18.3%); VF experience, 4242 (11.9%); and HF/FF experience, 2112 (5.9%). Osteoporosis was a significant risk factor for VF [HR 1.75, 95% confidence interval (CI)1.64-1.87]and HF/FF (HR 1.37, 95% CI 1.24-1.51). The cumulative incidence of VF and HF/FF was the highest at 6 months and increased more than half in the coming 2 years after PD diagnosis. Conclusions/Implications: VF and HF/FF are common among PD patients. VF and HF/FF risks were high for female PD patients aged ≥60 years with osteoporosis. Fracture prevention strategies should be focused on older, women, and osteoporosis patients within 3 years of PD diagnosis.

Original languageEnglish
Pages (from-to)617-623
Number of pages7
JournalJournal of the American Medical Directors Association
Volume20
Issue number5
DOIs
StatePublished - 1 May 2019

Fingerprint

Femoral Fractures
Hip Fractures
Korea
Parkinson Disease
Osteoporosis
Incidence
Parkinson Disease 5
Confidence Intervals
International Classification of Diseases
Censuses
Proportional Hazards Models
Social Class
Cohort Studies
Retrospective Studies
Demography
Databases

Keywords

  • Parkinson's disease
  • femur
  • fracture
  • hip
  • osteoporosis
  • vertebrae

Cite this

@article{1e329268b4cc46c9980e116e6874f762,
title = "Risk Factors for Vertebral, Hip, and Femoral Fractures Among Patients With Parkinson's Disease: A 5-Year Follow-up in Korea",
abstract = "Objectives: To investigate the prevalence and incidence of Parkinson's disease (PD)and provide evidence for preventive strategy of vertebral, hip, and femoral fractures (VF, HF, and FF)in PD patients. Design: Retrospective cohort study. Setting and Participants: Using a nationwide medical service utility database from 2009 to 2014, we enrolled PD patients with diagnosis of G20 as per ICD-10 who used medical services. Overall, the number of PD patients was 97,311, 106,072, 115,762, 127,647, 137,782, and 144,757 through 2009-2014, respectively. We followed 35,663 patients diagnosed with PD in 2010 without prior fracture. Measures: We estimated the annual PD prevalence and incidence and used Cox proportional hazards model to estimate the hazards ratio (HR)for factures based on demographic characteristics, underlying disease, and socioeconomic status according to fracture type (osteoporosis-related fracture, VF, HF/FF). Furthermore, we investigated the cumulative incidence of those fractures by month during the 5-year follow-up. Results: The standardized PD prevalence increased from 238 to 279 between 2009 and 2014, and its incidence decreased from 86 to 72 between 2010 and 2014 per 100,000 population based on 2015 census data. We followed 35,663 PD patients: women, 20,732 (58.1{\%}); aged ≥60 years, 29,264 (82.1{\%}); with osteoporosis, 6542 (18.3{\%}); VF experience, 4242 (11.9{\%}); and HF/FF experience, 2112 (5.9{\%}). Osteoporosis was a significant risk factor for VF [HR 1.75, 95{\%} confidence interval (CI)1.64-1.87]and HF/FF (HR 1.37, 95{\%} CI 1.24-1.51). The cumulative incidence of VF and HF/FF was the highest at 6 months and increased more than half in the coming 2 years after PD diagnosis. Conclusions/Implications: VF and HF/FF are common among PD patients. VF and HF/FF risks were high for female PD patients aged ≥60 years with osteoporosis. Fracture prevention strategies should be focused on older, women, and osteoporosis patients within 3 years of PD diagnosis.",
keywords = "Parkinson's disease, femur, fracture, hip, osteoporosis, vertebrae",
author = "Park, {Sung Bae} and Chung, {Chun Kee} and Lee, {Jee Young} and Jinyong Lee and Jayeun Kim",
year = "2019",
month = "5",
day = "1",
doi = "10.1016/j.jamda.2018.08.014",
language = "English",
volume = "20",
pages = "617--623",
journal = "Journal of the American Medical Directors Association",
issn = "1525-8610",
publisher = "Elsevier Inc.",
number = "5",

}

Risk Factors for Vertebral, Hip, and Femoral Fractures Among Patients With Parkinson's Disease : A 5-Year Follow-up in Korea. / Park, Sung Bae; Chung, Chun Kee; Lee, Jee Young; Lee, Jinyong; Kim, Jayeun.

In: Journal of the American Medical Directors Association, Vol. 20, No. 5, 01.05.2019, p. 617-623.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Risk Factors for Vertebral, Hip, and Femoral Fractures Among Patients With Parkinson's Disease

T2 - A 5-Year Follow-up in Korea

AU - Park, Sung Bae

AU - Chung, Chun Kee

AU - Lee, Jee Young

AU - Lee, Jinyong

AU - Kim, Jayeun

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Objectives: To investigate the prevalence and incidence of Parkinson's disease (PD)and provide evidence for preventive strategy of vertebral, hip, and femoral fractures (VF, HF, and FF)in PD patients. Design: Retrospective cohort study. Setting and Participants: Using a nationwide medical service utility database from 2009 to 2014, we enrolled PD patients with diagnosis of G20 as per ICD-10 who used medical services. Overall, the number of PD patients was 97,311, 106,072, 115,762, 127,647, 137,782, and 144,757 through 2009-2014, respectively. We followed 35,663 patients diagnosed with PD in 2010 without prior fracture. Measures: We estimated the annual PD prevalence and incidence and used Cox proportional hazards model to estimate the hazards ratio (HR)for factures based on demographic characteristics, underlying disease, and socioeconomic status according to fracture type (osteoporosis-related fracture, VF, HF/FF). Furthermore, we investigated the cumulative incidence of those fractures by month during the 5-year follow-up. Results: The standardized PD prevalence increased from 238 to 279 between 2009 and 2014, and its incidence decreased from 86 to 72 between 2010 and 2014 per 100,000 population based on 2015 census data. We followed 35,663 PD patients: women, 20,732 (58.1%); aged ≥60 years, 29,264 (82.1%); with osteoporosis, 6542 (18.3%); VF experience, 4242 (11.9%); and HF/FF experience, 2112 (5.9%). Osteoporosis was a significant risk factor for VF [HR 1.75, 95% confidence interval (CI)1.64-1.87]and HF/FF (HR 1.37, 95% CI 1.24-1.51). The cumulative incidence of VF and HF/FF was the highest at 6 months and increased more than half in the coming 2 years after PD diagnosis. Conclusions/Implications: VF and HF/FF are common among PD patients. VF and HF/FF risks were high for female PD patients aged ≥60 years with osteoporosis. Fracture prevention strategies should be focused on older, women, and osteoporosis patients within 3 years of PD diagnosis.

AB - Objectives: To investigate the prevalence and incidence of Parkinson's disease (PD)and provide evidence for preventive strategy of vertebral, hip, and femoral fractures (VF, HF, and FF)in PD patients. Design: Retrospective cohort study. Setting and Participants: Using a nationwide medical service utility database from 2009 to 2014, we enrolled PD patients with diagnosis of G20 as per ICD-10 who used medical services. Overall, the number of PD patients was 97,311, 106,072, 115,762, 127,647, 137,782, and 144,757 through 2009-2014, respectively. We followed 35,663 patients diagnosed with PD in 2010 without prior fracture. Measures: We estimated the annual PD prevalence and incidence and used Cox proportional hazards model to estimate the hazards ratio (HR)for factures based on demographic characteristics, underlying disease, and socioeconomic status according to fracture type (osteoporosis-related fracture, VF, HF/FF). Furthermore, we investigated the cumulative incidence of those fractures by month during the 5-year follow-up. Results: The standardized PD prevalence increased from 238 to 279 between 2009 and 2014, and its incidence decreased from 86 to 72 between 2010 and 2014 per 100,000 population based on 2015 census data. We followed 35,663 PD patients: women, 20,732 (58.1%); aged ≥60 years, 29,264 (82.1%); with osteoporosis, 6542 (18.3%); VF experience, 4242 (11.9%); and HF/FF experience, 2112 (5.9%). Osteoporosis was a significant risk factor for VF [HR 1.75, 95% confidence interval (CI)1.64-1.87]and HF/FF (HR 1.37, 95% CI 1.24-1.51). The cumulative incidence of VF and HF/FF was the highest at 6 months and increased more than half in the coming 2 years after PD diagnosis. Conclusions/Implications: VF and HF/FF are common among PD patients. VF and HF/FF risks were high for female PD patients aged ≥60 years with osteoporosis. Fracture prevention strategies should be focused on older, women, and osteoporosis patients within 3 years of PD diagnosis.

KW - Parkinson's disease

KW - femur

KW - fracture

KW - hip

KW - osteoporosis

KW - vertebrae

UR - http://www.scopus.com/inward/record.url?scp=85055213519&partnerID=8YFLogxK

U2 - 10.1016/j.jamda.2018.08.014

DO - 10.1016/j.jamda.2018.08.014

M3 - Article

VL - 20

SP - 617

EP - 623

JO - Journal of the American Medical Directors Association

JF - Journal of the American Medical Directors Association

SN - 1525-8610

IS - 5

ER -