A service development study of the assessment and management of fracture risk in Parkinson’s disease
Parkinson’s disease (PD) is associated with an increased risk of fragility fracture. FRAX and Qfracture are risk calculators that estimate the 10-year risk of hip and major fractures and guide definitive investigation for osteoporosis using dual X-ray absorptiometry (DEXA) imaging. It is unclear whi...
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| Veröffentlicht in: | Journal of neurology 2014-06, Vol.261 (6), p.1153-1159 |
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| creator | Shribman, Samuel Torsney, Kelli M. Noyce, Alastair J. Giovannoni, Gavin Fearnley, Julian Dobson, Ruth |
| description | Parkinson’s disease (PD) is associated with an increased risk of fragility fracture. FRAX and Qfracture are risk calculators that estimate the 10-year risk of hip and major fractures and guide definitive investigation for osteoporosis using dual X-ray absorptiometry (DEXA) imaging. It is unclear which PD patients should be considered for fracture risk assessment and whether FRAX or Qfracture should be used. Seventy-seven patients with PD were recruited in the movement disorders clinic. Data were collected on PD-related characteristics and fracture risk scores were calculated. Patients with previous osteoporotic fractures had a higher incidence of falls (
p
= 0.0026) and use of bilateral walking aids (
p
= 0.0187) in addition to longer disease duration (
p
= 0.0037). Selecting patients with falls in combination with either disease duration >5 years, bilateral walking aids, or previous osteoporotic fracture distinguished patients with and without previous osteoporotic fracture with specificity 67.7 % (95 % CI 55.0–78.8) and sensitivity 100.0 % (95 % CI 73.5–100.0). Qfracture calculated significantly higher fracture risk scores than FRAX for hip (
p
|
| doi_str_mv | 10.1007/s00415-014-7333-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4072921</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3333615591</sourcerecordid><originalsourceid>FETCH-LOGICAL-c573t-48ddb46233e3ace982405a395ba804ea0cfb39d50b638b45fadbfca1ccefd2a33</originalsourceid><addsrcrecordid>eNqFkc9u1DAQxi0EokvhAbggS1y4BMYZe5NckKqKf1IlOMDZcuzJNm3WWTzJSr31Nfp6fRK8u6UqSIiTZX-_-WbGnxAvFbxVANU7BtDKFKB0USFiUT8SC6WxLJQ2zWOxANRQGDT6SDxjvgCAOgtPxVGpK1U3NSxEdyKZ0rb3JANtaRg3a4qT5GkOV3Ls5HRO0jET8_7dxSDXLroV7a8Z6JLz05xIpp4vZR_lN5cu-8hjvL2-YRl6Jsf0XDzp3MD04u48Fj8-fvh--rk4-_rpy-nJWeFNhVOh6xBavSwRCZ2npi41GIeNaV0Nmhz4rsUmGGiXWLfadC60nXfKe-pC6RCPxfuD72Zu1xR8HjK5wW5Sv3bpyo6ut38qsT-3q3FrNVRlU6ps8ObOII0_Z-LJrnv2NAwu0jizVcboxpS7Ef-PolkiIOqMvv4LvRjnFPNP7KmcEJhdb3WgfBqZE3X3cyuwu8DtIXCbA7e7wG2da149XPi-4nfCGSgPAGcprig9aP1P11_2nbkR</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1535354051</pqid></control><display><type>article</type><title>A service development study of the assessment and management of fracture risk in Parkinson’s disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Shribman, Samuel ; Torsney, Kelli M. ; Noyce, Alastair J. ; Giovannoni, Gavin ; Fearnley, Julian ; Dobson, Ruth</creator><creatorcontrib>Shribman, Samuel ; Torsney, Kelli M. ; Noyce, Alastair J. ; Giovannoni, Gavin ; Fearnley, Julian ; Dobson, Ruth</creatorcontrib><description>Parkinson’s disease (PD) is associated with an increased risk of fragility fracture. FRAX and Qfracture are risk calculators that estimate the 10-year risk of hip and major fractures and guide definitive investigation for osteoporosis using dual X-ray absorptiometry (DEXA) imaging. It is unclear which PD patients should be considered for fracture risk assessment and whether FRAX or Qfracture should be used. Seventy-seven patients with PD were recruited in the movement disorders clinic. Data were collected on PD-related characteristics and fracture risk scores were calculated. Patients with previous osteoporotic fractures had a higher incidence of falls (
p
= 0.0026) and use of bilateral walking aids (
p
= 0.0187) in addition to longer disease duration (
p
= 0.0037). Selecting patients with falls in combination with either disease duration >5 years, bilateral walking aids, or previous osteoporotic fracture distinguished patients with and without previous osteoporotic fracture with specificity 67.7 % (95 % CI 55.0–78.8) and sensitivity 100.0 % (95 % CI 73.5–100.0). Qfracture calculated significantly higher fracture risk scores than FRAX for hip (
p
< 0.0001) and major (
p
= 0.0008) fracture in PD patients. Receiver operating characteristic curves demonstrated that FRAX outperformed Qfracture with an area under the curve of 0.84 (95 % CI 0.70–0.97,
p
= 0.0004) for FRAX and 0.68 (95 % CI 52–86,
p
= 0.0476) for Qfracture major fracture risk calculators. We suggest that falls in combination with either a disease duration longer than 5 years or bilateral walking aids or previous osteoporotic fracture should be used as red flags in PD patients to prompt clinicians to perform a FRAX fracture risk assessment in the neurology clinic.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-014-7333-8</identifier><identifier>PMID: 24718980</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Absorptiometry, Photon ; Adult ; Aged ; Aged, 80 and over ; Bisphosphonates ; Body mass index ; Bone density ; Cognitive ability ; Disease Management ; Female ; Fractures ; Hip joint ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurology ; Neuroradiology ; Neurosciences ; Original Communication ; Orthopedic apparatus ; Osteoporosis ; Osteoporotic Fractures - diagnosis ; Osteoporotic Fractures - etiology ; Osteoporotic Fractures - therapy ; Parkinson Disease - complications ; Parkinson's disease ; Patients ; Rheumatoid arthritis ; Risk assessment ; Risk Assessment - methods ; ROC Curve ; Surveys and Questionnaires ; Time Factors ; Walking - physiology</subject><ispartof>Journal of neurology, 2014-06, Vol.261 (6), p.1153-1159</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c573t-48ddb46233e3ace982405a395ba804ea0cfb39d50b638b45fadbfca1ccefd2a33</citedby><cites>FETCH-LOGICAL-c573t-48ddb46233e3ace982405a395ba804ea0cfb39d50b638b45fadbfca1ccefd2a33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-014-7333-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-014-7333-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24718980$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shribman, Samuel</creatorcontrib><creatorcontrib>Torsney, Kelli M.</creatorcontrib><creatorcontrib>Noyce, Alastair J.</creatorcontrib><creatorcontrib>Giovannoni, Gavin</creatorcontrib><creatorcontrib>Fearnley, Julian</creatorcontrib><creatorcontrib>Dobson, Ruth</creatorcontrib><title>A service development study of the assessment and management of fracture risk in Parkinson’s disease</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Parkinson’s disease (PD) is associated with an increased risk of fragility fracture. FRAX and Qfracture are risk calculators that estimate the 10-year risk of hip and major fractures and guide definitive investigation for osteoporosis using dual X-ray absorptiometry (DEXA) imaging. It is unclear which PD patients should be considered for fracture risk assessment and whether FRAX or Qfracture should be used. Seventy-seven patients with PD were recruited in the movement disorders clinic. Data were collected on PD-related characteristics and fracture risk scores were calculated. Patients with previous osteoporotic fractures had a higher incidence of falls (
p
= 0.0026) and use of bilateral walking aids (
p
= 0.0187) in addition to longer disease duration (
p
= 0.0037). Selecting patients with falls in combination with either disease duration >5 years, bilateral walking aids, or previous osteoporotic fracture distinguished patients with and without previous osteoporotic fracture with specificity 67.7 % (95 % CI 55.0–78.8) and sensitivity 100.0 % (95 % CI 73.5–100.0). Qfracture calculated significantly higher fracture risk scores than FRAX for hip (
p
< 0.0001) and major (
p
= 0.0008) fracture in PD patients. Receiver operating characteristic curves demonstrated that FRAX outperformed Qfracture with an area under the curve of 0.84 (95 % CI 0.70–0.97,
p
= 0.0004) for FRAX and 0.68 (95 % CI 52–86,
p
= 0.0476) for Qfracture major fracture risk calculators. We suggest that falls in combination with either a disease duration longer than 5 years or bilateral walking aids or previous osteoporotic fracture should be used as red flags in PD patients to prompt clinicians to perform a FRAX fracture risk assessment in the neurology clinic.</description><subject>Absorptiometry, Photon</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bisphosphonates</subject><subject>Body mass index</subject><subject>Bone density</subject><subject>Cognitive ability</subject><subject>Disease Management</subject><subject>Female</subject><subject>Fractures</subject><subject>Hip joint</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Orthopedic apparatus</subject><subject>Osteoporosis</subject><subject>Osteoporotic Fractures - diagnosis</subject><subject>Osteoporotic Fractures - etiology</subject><subject>Osteoporotic Fractures - therapy</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson's disease</subject><subject>Patients</subject><subject>Rheumatoid arthritis</subject><subject>Risk assessment</subject><subject>Risk Assessment - methods</subject><subject>ROC Curve</subject><subject>Surveys and Questionnaires</subject><subject>Time Factors</subject><subject>Walking - physiology</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc9u1DAQxi0EokvhAbggS1y4BMYZe5NckKqKf1IlOMDZcuzJNm3WWTzJSr31Nfp6fRK8u6UqSIiTZX-_-WbGnxAvFbxVANU7BtDKFKB0USFiUT8SC6WxLJQ2zWOxANRQGDT6SDxjvgCAOgtPxVGpK1U3NSxEdyKZ0rb3JANtaRg3a4qT5GkOV3Ls5HRO0jET8_7dxSDXLroV7a8Z6JLz05xIpp4vZR_lN5cu-8hjvL2-YRl6Jsf0XDzp3MD04u48Fj8-fvh--rk4-_rpy-nJWeFNhVOh6xBavSwRCZ2npi41GIeNaV0Nmhz4rsUmGGiXWLfadC60nXfKe-pC6RCPxfuD72Zu1xR8HjK5wW5Sv3bpyo6ut38qsT-3q3FrNVRlU6ps8ObOII0_Z-LJrnv2NAwu0jizVcboxpS7Ef-PolkiIOqMvv4LvRjnFPNP7KmcEJhdb3WgfBqZE3X3cyuwu8DtIXCbA7e7wG2da149XPi-4nfCGSgPAGcprig9aP1P11_2nbkR</recordid><startdate>20140601</startdate><enddate>20140601</enddate><creator>Shribman, Samuel</creator><creator>Torsney, Kelli M.</creator><creator>Noyce, Alastair J.</creator><creator>Giovannoni, Gavin</creator><creator>Fearnley, Julian</creator><creator>Dobson, Ruth</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140601</creationdate><title>A service development study of the assessment and management of fracture risk in Parkinson’s disease</title><author>Shribman, Samuel ; Torsney, Kelli M. ; Noyce, Alastair J. ; Giovannoni, Gavin ; Fearnley, Julian ; Dobson, Ruth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c573t-48ddb46233e3ace982405a395ba804ea0cfb39d50b638b45fadbfca1ccefd2a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Absorptiometry, Photon</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bisphosphonates</topic><topic>Body mass index</topic><topic>Bone density</topic><topic>Cognitive ability</topic><topic>Disease Management</topic><topic>Female</topic><topic>Fractures</topic><topic>Hip joint</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Original Communication</topic><topic>Orthopedic apparatus</topic><topic>Osteoporosis</topic><topic>Osteoporotic Fractures - diagnosis</topic><topic>Osteoporotic Fractures - etiology</topic><topic>Osteoporotic Fractures - therapy</topic><topic>Parkinson Disease - complications</topic><topic>Parkinson's disease</topic><topic>Patients</topic><topic>Rheumatoid arthritis</topic><topic>Risk assessment</topic><topic>Risk Assessment - methods</topic><topic>ROC Curve</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><topic>Walking - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shribman, Samuel</creatorcontrib><creatorcontrib>Torsney, Kelli M.</creatorcontrib><creatorcontrib>Noyce, Alastair J.</creatorcontrib><creatorcontrib>Giovannoni, Gavin</creatorcontrib><creatorcontrib>Fearnley, Julian</creatorcontrib><creatorcontrib>Dobson, Ruth</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shribman, Samuel</au><au>Torsney, Kelli M.</au><au>Noyce, Alastair J.</au><au>Giovannoni, Gavin</au><au>Fearnley, Julian</au><au>Dobson, Ruth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A service development study of the assessment and management of fracture risk in Parkinson’s disease</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2014-06-01</date><risdate>2014</risdate><volume>261</volume><issue>6</issue><spage>1153</spage><epage>1159</epage><pages>1153-1159</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>Parkinson’s disease (PD) is associated with an increased risk of fragility fracture. FRAX and Qfracture are risk calculators that estimate the 10-year risk of hip and major fractures and guide definitive investigation for osteoporosis using dual X-ray absorptiometry (DEXA) imaging. It is unclear which PD patients should be considered for fracture risk assessment and whether FRAX or Qfracture should be used. Seventy-seven patients with PD were recruited in the movement disorders clinic. Data were collected on PD-related characteristics and fracture risk scores were calculated. Patients with previous osteoporotic fractures had a higher incidence of falls (
p
= 0.0026) and use of bilateral walking aids (
p
= 0.0187) in addition to longer disease duration (
p
= 0.0037). Selecting patients with falls in combination with either disease duration >5 years, bilateral walking aids, or previous osteoporotic fracture distinguished patients with and without previous osteoporotic fracture with specificity 67.7 % (95 % CI 55.0–78.8) and sensitivity 100.0 % (95 % CI 73.5–100.0). Qfracture calculated significantly higher fracture risk scores than FRAX for hip (
p
< 0.0001) and major (
p
= 0.0008) fracture in PD patients. Receiver operating characteristic curves demonstrated that FRAX outperformed Qfracture with an area under the curve of 0.84 (95 % CI 0.70–0.97,
p
= 0.0004) for FRAX and 0.68 (95 % CI 52–86,
p
= 0.0476) for Qfracture major fracture risk calculators. We suggest that falls in combination with either a disease duration longer than 5 years or bilateral walking aids or previous osteoporotic fracture should be used as red flags in PD patients to prompt clinicians to perform a FRAX fracture risk assessment in the neurology clinic.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24718980</pmid><doi>10.1007/s00415-014-7333-8</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of neurology, 2014-06, Vol.261 (6), p.1153-1159 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Absorptiometry, Photon Adult Aged Aged, 80 and over Bisphosphonates Body mass index Bone density Cognitive ability Disease Management Female Fractures Hip joint Humans Male Medicine Medicine & Public Health Middle Aged Neurology Neuroradiology Neurosciences Original Communication Orthopedic apparatus Osteoporosis Osteoporotic Fractures - diagnosis Osteoporotic Fractures - etiology Osteoporotic Fractures - therapy Parkinson Disease - complications Parkinson's disease Patients Rheumatoid arthritis Risk assessment Risk Assessment - methods ROC Curve Surveys and Questionnaires Time Factors Walking - physiology |
| title | A service development study of the assessment and management of fracture risk in Parkinson’s disease |
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