Friday 19 October 2018

Link Between Osteoporosis and Parkinson

Osteoporosis is a bone disease caused by the reduction of bone mass and deterioration of bone tissue, resulting in fractures.  Parkinson's disease is a neurodegenerative disorder with loss of motor control. Patients with Parkinson's disease are at higher risk of developing osteoporosis due to their limited activity, lower muscle strength an bone mass.
A research paper submitted at the American Academy of Neurology in 2006 clearly highlights the danger of osteoporosis in PD patients. Of the 166 Parkinson's patients studied, nearly 51 % of the females and 29% of the men had osteoporosis. A number of them also had osteopenia or lowered bone mass- 45% of the women and 48% of the men. This firmly establishes the link between osteoporosis and Parkinson's disease.

Parkinson's disease symptoms that may lead to osteoporosis


  • Tremors

Incessant shaking or tremors are the first and early sign of Parkinson's. This uncontrollable shaking is due to loss of nerve control and it severely affects Parkinson's patients. It also hampers the free movement and routine activities of the PD patients, resulting in the quick onset of osteoporosis.

  • Reduced movement

Patient's with Parkinson's find it difficult to move freely as they have poor posture, balance and  reduced bone and muscle strength. All this prevents them from leading an active life with ample movement. This reduced movement and lack of mobile activity lead to osteoporosis.

  • Slow gait

Parkinson's patients exhibit slow gait due to loss of motor function. They lack control of their movements and body balance and hence move in a stumbling manner. This slow gait may lead due to loss of bone mass and osteoporosis.

  • Bradykinesia

Bradykinesia or slow movement is another Parkinson's disease symptom that may lead to osteoporosis. Poor nerve and muscular strength and coordination is the reason for the slowed movement in PD patients. This lethargic movement may cause osteoporosis if not attended to immediately.

  • Akinesia

The rigidity of muscles or akinesia is another PD symptom that increases the risk of osteoporosis. Caused due to muscular stiffness due to impaired movement, akinesia may reduce muscle and bone strength and cause osteoporosis.

  • Vitamin D deficiency

Due to decreased activity and exposure to sunlight, Vitamin D deficiency occurs in PD patients. this reduces bone mass and density leading to osteoporosis.
All the above Parkinson's disease symptoms may accelerate the risk and incidence of osteoporosis in PD patients but can be effectively controlled and cured with regular exercise and  the right medication.

Osteoporosis medications for PD patients

Parkinson's patients are treated with Levodopa as a form of medication. This Levodopa treatment is found to increase the level of homocysteine in the blood and this may further on lead to osteoporosis in PD patients. This condition called "hyperhomocysteinemia" is peculiar to PD patients and causes osteopenia or lowered bone mass which is the first among osteoporosis disease stages.
The only way to arrest this medical problem in PD patients taking Levodopa is to give them additional B12 and Folic acid supplementation to reduce elevated homocysteine levels, thereby preventing osteoporosis.
PD patients also consume SSRI antidepressants to prevent depression. These antipsychotic drugs can increase the risk of hip fractures. Instead, tricyclic anti depressants can be used for such depressed D patients as they do not increase the risk of osteoporotic fractures.
In addition, PD patients have to be treated for reduced bone mass density, calcium and Vitamin D deficiency. A dietary intake of 1200-1500 mg of calcium is a must for PD patients along with enough Vitamin D for its bone absorption.
Biphosphonates like alendronate or risedronate are best recommended to treat osteoporosis in PD patients. Use of these osteoporosis medications can help them combat osteoporosis effectively and completely.
Parkinson's disease is not a singular disease but it is accompanied by a host of other associated medical ailments like osteoporosis. Osteoporosis in PD patients must be addressed immediately with awareness, exercise and medication.

No comments:

Post a Comment