Taggart H, Crawford V
Department of Health Care for the Elderly, Belfast City Hospital.
Age Ageing. 1995 Jul;24(4):326-8. doi: 10.1093/ageing/24.4.326.
Parkinson's disease (PD) is a major cause of falls and reduced mobility in elderly people. Fractures often occur as a result of these falls but there have been no studies of bone mineral density (BMD) in PD. We have prospectively studied 29 elderly women (mean age 77 years) and 26 elderly men (mean age 74 years) with PD over 2 years and compared them with similar numbers of age- and sex-matched controls. Bone mineral density was measured by dual X-ray absorptiometry. Women were more likely to sustain fractures (38% compared with 8% of men). Mean BMD of the lumbar spine was similar in the 55 combined PD patients compared with combined controls. However, the total hip BMD was 10% lower (p = 0.014) and the neck of femur BMD 12% lower (p < 0.004) in the 51 PD patients compared with controls. The relatively lower hip BMD in elderly PD men and women combined with their abnormal gait and tendency to fall backwards or to the side may explain their excess risk of hip fractures, particularly in women. The neuromuscular deficit in PD may differentially reduce hip BMD relative to other sites and may thus be amenable to measures designed to improve mechanical loading in the lower limbs in the early stages of PD.
帕金森病（PD）是老年人跌倒和行动能力下降的主要原因。这些跌倒常常导致骨折，但尚未有关于帕金森病患者骨密度（BMD）的研究。我们对29名老年女性（平均年龄77岁）和26名老年男性（平均年龄74岁）的帕金森病患者进行了为期2年的前瞻性研究，并将他们与相同数量的年龄和性别匹配的对照组进行比较。通过双能X线吸收法测量骨密度。女性比男性更容易发生骨折（分别为38%和8%）。55名帕金森病患者合并组的腰椎平均骨密度与对照组合并组相似。然而，与对照组相比，51名帕金森病患者的全髋骨密度低10%（p = 0.014），股骨颈骨密度低12%（p < 0.004）。老年帕金森病男性和女性相对较低的髋部骨密度，再加上他们异常的步态以及向后或向一侧跌倒的倾向，可能解释了他们髋部骨折风险过高的原因，尤其是在女性中。帕金森病中的神经肌肉缺陷可能相对于其他部位有差异地降低髋部骨密度，因此在帕金森病早期阶段可能适合采取旨在改善下肢机械负荷的措施。
