Ostéoporose et maladie de Parkinson

Abstract

Patients with Parkinson's disease, as well as those affected by stroke or spinal cord injury, show an increased risk of falls and have an increased incidence of severe osteoporosis fractures, especially femoral neck fractures compared with age-matched healthy subjects. In Parkinson's disease patients, osteoporosis is secondary to several factors present in advanced neurological disease as well as early stages of the illness, including immobilisation, endocrine imbalance, 25-(OH)D deficiency and poor nutritional status. Considering the morbidity and mortality related to hip fractures in general population and specifically in Parkinson's disease patients, all these factors should be evaluated at diagnosis and should be regularly checked throughout follow-up. Due to the higher risk of fractures and uncertainties about the interaction between levodopa use and bone mineral density, whether the threshold for intervention and diagnosis might have to be set at a higher level than generally recommended for postmenopausal osteoporosis, remains to be evaluated.