Improving Bone Health In Parkinson’s Disease

By Dr Ghalib Choudhury, SpR Geriatric Medicine, Cambridge University Hospitals NHS Foundation Trust



A systematic review and meta-analysis found PwPD had a higher risk of osteoporosis (OR 2.61; 95% CI 1.69 to 4.03) compared to healthy controls.

The combined effect size was 2.28; 95% CI 1.83 to 2.83. Of these, three studies had a combined HR of 2.10, 95% CI 1.55 to 2.86; four studies had a combined OR of 4.01, 95% CI 1.77 to 9.04; and two studies had a combined RR of 2.13, 95% CI 1.68 to 2.69.

Hip fractures are a particular risk

PwPD have an increased risk for both hip fractures (2.40, 95% CI 2.04 to 2.82) and non-vertebral fractures (1.80, 95% CI 1.60 to 2.01) compared to controls.

The relative risk for hip fractures was higher in men (2.93, 95% CI 2.05 to 4.18) than in women (1.81, 95% CI 1.61 to 2.04).


We had three key questions;

  1. What percentage of PwPD admitted to hospital have a history of falls and / or fractures?
  2. How many PwPD admitted to hospital have evidence of a bone health assessment including treatment where appropriate?
  3. What percentage of PwPD are reviewed proactively by the PD inpatient service?

More Parkinson's Academy Falls & bone health Projects

'The things you can't get from the books'

Parkinson's Academy, our original and longest running Academy, houses 22 years of inspirational projects, resources, and evidence for improving outcomes for people with Parkinson's. Led by co-founder and educational director Dr Peter Fletcher, the Academy has a truly collegiate feel and prides itself on delivering 'the things you can't get from books' - a practical learning model which inspires all Neurology Academy courses.