Metta Vinod, Sanchez Tamara C, Padmakumar Chandrasekhara
Imperial College Hospitals NHS, London, United Kingdom; University College London, London, United Kingdom.
Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Int Rev Neurobiol. 2017;134:877-890. doi: 10.1016/bs.irn.2017.05.034. Epub 2017 Jul 10.
Osteoporosis is a "hidden nonmotor face" of Parkinson's disease and a cause of considerable morbidity in the older general population and in Parkinson's disease patients. Some regard this as a "hidden epidemic." Women are overrepresented and have considerable problems related to osteoporosis. In general osteoporosis leads to reduced mobility aggravating the motor syndrome of PD. The nonmotor aspects and impact of osteoporosis in PD have remained unexplored. Possible nonmotor consequences include a range of pain syndromes related to local pain, fractures, falls, and injuries as well as pathological fractures and radiculopathy. In addition depression, sleep dysfunction, dementia, as well as fear of falling also complicate the clinical picture. Quality of life deteriorates both for the patient and career. Pathways of care do not always include assessments for osteoporosis and needs to become obligatory particularly in older female PD patients. Active management strategies then need to be undertaken for osteoporosis in PD. Related motor and nonmotor consequences also highlight the importance of multidisciplinary treatment in PD particularly when dealing with osteoporosis.
骨质疏松症是帕金森病的“隐匿性非运动面容”，也是老年普通人群和帕金森病患者发病的重要原因。有人将此视为一种“隐匿性流行病”。女性患者比例过高，且存在与骨质疏松症相关的诸多问题。一般来说，骨质疏松症会导致活动能力下降，加重帕金森病的运动综合征。骨质疏松症在帕金森病中的非运动方面及其影响尚未得到充分研究。可能的非运动后果包括一系列与局部疼痛、骨折、跌倒和损伤相关的疼痛综合征，以及病理性骨折和神经根病。此外，抑郁、睡眠功能障碍、痴呆以及跌倒恐惧也会使临床情况更加复杂。患者和护理人员的生活质量都会下降。护理途径并不总是包括对骨质疏松症的评估，这需要成为强制性要求，尤其是在老年女性帕金森病患者中。然后需要针对帕金森病患者的骨质疏松症采取积极的管理策略。相关的运动和非运动后果也凸显了帕金森病多学科治疗的重要性，尤其是在处理骨质疏松症时。
