Incidence of hip fracture in Parkinson disease: a population-based study in British Columbia, Canada

Aims Parkinson's disease (PD) constitutes a significant risk for falls and subsequent hip fracture, yet the rate of hip fracture in this patient population has not been clearly delineated. We looked at the incidence rate of hip fracture in a provincial-based population 65 years or older who had PD. Methods To identify PD cases record linkage of inpatient hospitalisation, physician billing and prescription records were examined for PD specific diagnostic codes for British Columbia, Canada. Hip fracture cases were identified using the International Classification of Diseases Version 9 codes. Data for the fiscal years 1991/92 to 2000/2001 were stratified by year, age group, sex. Incidence rates of hip fractures in PD were calculated using prevalent PD cases in year as the denominator. Results For females rates of hip fracture were the highest in first years of the study peaking at 31.0/1000 PD case in 1991/92 and dropping to 20.8/1000 in 1999/00. Female's rates were consistently about 1.7 times that of male rates. The male rate of hip fracture peaked in 1993/94 at 19.8/1000 PD cases dropping to 12.6/1000 in 1999/00. Rates increased with age in both sexes. Conclusions The PD population appears to be at greater risk (3 to 4 times) of hip fracture when compared to rates reported for the general Canadian population. The differential in rates appears to be most apparent in younger PD (