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Publication - Dr Celia Gregson

    Management of fracture risk in Parkinson's

    A revised algorithm and focused review of treatments

    Citation

    Henderson, E, Lyell, V, Bhimjiyani, A, Amin, J, Kobylecki, C & Gregson, C, 2019, ‘Management of fracture risk in Parkinson's: A revised algorithm and focused review of treatments’. Parkinsonism and Related Disorders.

    Abstract

    Introduction
    Falls and fractures are a cause of substantial morbidity in Parkinson's. Despite an excess risk of both falls and osteoporosis, people with Parkinson's perceive that they are less likely to fracture than their peers, despite actually being at higher fracture risk. Recognising this increased risk, in 2014 we published an algorithm to guide management of fracture risk in this high-risk population. Recently, the National Osteoporosis Guideline Group (NOGG) published new guidance revising the 10 year fracture probability intervention thresholds for those over 70 years old to 20.3% for major osteoporotic fracture and 5.4% for hip fracture.

    Methods
    In light of the new guidance, we have reappraised the use of two fracture prediction tools, Qfracture and FRAX, and have updated the algorithm to guide the management of bone health and fracture risk in people with Parkinson's.

    Results
    We outline the treatment options available with particular consideration given to Parkinson specific factors that influence treatment choices.

    Conclusion
    This guidance is relevant to all healthcare specialist managing Parkinson's including neurologists, geriatricians and primary care practitioners.

    Full details in the University publications repository