Jump to content


E-Newsletter Signup Like us on Facebook Sign Up For Our e-Newsletter
Photo

Post of the Week: Bone Health in Parkinson's Disease


  • Please log in to reply
2 replies to this topic

#1 Dr. Okun

Dr. Okun

    Advanced Member

  • Ask the Doctor Moderators
  • PipPipPip
  • 4,640 posts
  • LocationUniversity of Florida

Posted 04 September 2009 - 12:29 PM

Take Care of Your Bones as They Are Affected in Parkinson’s Disease (Even in Men)

Michael S. Okun, M.D.
National Medical Director, National Parkinson Foundation

What’s Hot in Parkinson’s Disease: September 2009

Last month Abou-Raya and colleagues from Alexandria, Egypt offered us a sobering reminder that the bones are often involved and may be “sick” in Parkinson’s disease patients. They looked at bone health in 82 patients with Parkinson’s disease, and in 68 control patients free of neurological disease. What they discovered was that there were striking differences. The bone mineral densities of all the Parkinson’s disease patients when compared to control subjects revealed: vitamin D levels were depressed, there were more falls, there were more fractures, and there was more osteoporosis. A careful look through the published literature on Parkinson’s disease shockingly reveals that scientists have been aware of bone problems for many years. DEXA bone scans have been shown to be abnormal in both men and women with Parkinson’s disease, and Fink and colleagues have shown that Parkinson’s disease patients had lower bone mineral densities at the hip and spine, a greater number of falls, and a greater amount of osteoporosis. Geriatrician’s may in some cases diminish the importance of bone findings in Parkinson’s disease by pointing out that a lack of movement should be associated with diminished bone mineral density. However, as the picture begins to come into focus on this critical issue we are learning that the degenerative process in Parkinson’s disease involves the hypothalamus and other brain areas that are likely intimately tied to bone health. Thus, an alternative hypothesis would be that although there is a lack of movement in Parkinson’s disease patients, the main cause for bone density problems is brain degeneration. More research will be needed to elucidate the factors related to bone density in Parkinson’s disease (medication, disease duration, etc.)

If we know that the bones are affected in Parkinson’s disease, and that both men and women are affected, why are we not more vigilant in screening for this treatable problem? In our UF clinic one of our students Sara Daniel, who has a scholarship from the Howard Hughes program for medical research, has been screening the Parkinson’s disease population and many patients in her study are now aware of their bone density status—and consequently they seek treatment. It is time for us to get the word out to Parkinson’s disease patients-- they need regular bone mineral density screenings-- and if abnormal they need to seek treatment. Having strong bones has a lot of potential benefits, not the least of which is the potential of preventing a post-fall fracture.


Selected References:

Abou-Raya S, Helmii M, Abou-Raya A.
Age Ageing. Bone and mineral metabolism in older adults with Parkinson's disease.
2009 Aug 15.

Fink HA, Kuskowski MA, Orwoll ES, Cauley JA, Ensrud KE; Osteoporotic Fractures in Men (MrOS) Study Group.
Association between Parkinson's disease and low bone density and falls in older men: the osteoporotic fractures in men study. J Am Geriatr Soc. 2005 Sep;53(9):1559-64.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#2 Guest__*

Guest__*
  • Guests

Posted 05 November 2009 - 06:50 PM

This is fascinating.

I consider my self very fortunate that I, being male, was diagnosed with severe osteoporosis when I was only 54 years old and have been treated for it even since including taking forteo injections the last two years (synthetic parathyroid). My endocrinologist also has a very difficult time getting my vitamin D levels up to normal. i was diagnosed with Parkinson's about 5 years after i was diagnosed with the osteoporosis.

I would strongly advise anyone with PD to get a bone density done immediately if they haven't already. My mother had osteoporosis so severe by her early 60's that she could not sit up because her spine would crush. She was in agony 24/7 with no relief. This is a horrible problem so get treated immediately and stick with it!

Thanks to my treatment although my hips are very low density and at a strong risk for fracture despite all the treatment, my spine is in good shape and I've had no fractures that were not the result of a fairly severe fall - like onto the edge of a pickup truck tail gate when I slipped off the bumper in the rain, and I can walk and function normally at nearly 70. Without treatment I'd have been in a nursing home or dead by now. i was down three standard deviations ten years ago. You can imagine where I'd be now without treatment.

#3 Dr. Okun

Dr. Okun

    Advanced Member

  • Ask the Doctor Moderators
  • PipPipPip
  • 4,640 posts
  • LocationUniversity of Florida

Posted 06 November 2009 - 03:21 AM

Thank you for the wonderful comment, I completely agree with you on the bone density test!
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips




0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users