Anti-osteoporosis medications in persons with and without Parkinson disease in Finland

Abstract Summary Contrary to reports on under-treatment in persons with Parkinson’s disease, our study found similar anti-osteoporosis medication usage before and after their hip fractures among Finns with and without Parkinson’s disease. Additional preventive measures may be needed to mitigate the high risk of hip fractures among persons with Parkinson’s disease. Purpose Parkinson’s disease (PD) is associated with a doubled risk of hip fracture. However, previous reports suggest under-recognition of osteoporosis among persons with PD. Our study aimed to assess the annual prevalence of anti-osteoporosis medications among persons with and without PD in relation to diagnosis of PD and hip fractures. Methods Our nationwide matched cohort design included 33,153 persons diagnosed with incident PD between 2000 and 2009 in Finland and 1:2 matched comparison cohort. Persons with previous hip fractures were excluded. Annual prevalences of anti-osteoporosis medications were calculated for each year between 5 years before and 10 years after diagnosis of PD, and between 5 years before and 5 years after the incident hip fractures. Results Prevalence of anti-osteoporosis medications was higher in persons with PD (3.62%, 95% confidence interval [CI] 3.28–3.98%) than those without PD (2.91%, 95% CI 2.70–3.14%), starting from 3 years before the diagnosis. Among individuals with incident hip fractures (1475 [13%] persons with PD and 1371 [6%] persons without PD), the annual prevalence were similar among persons with PD and without PD, peaking within 1 year after hip fractures (with PD: 20.3%, 95% CI 18.0–22.8%; without PD: 21.0%, 95% CI 18.5–23.6%). Conclusion Contrary to reports on under-treatment in persons with PD, our study found similar anti-osteoporosis medication usage before and after their hip fractures among Finns with and without PD. Additional preventive measures, such as regular review of fall risk, is needed to mitigate the doubled risk of hip fracture in PD.