Osteoporosis care in the context of a diagnosis of Parkinson’s disease: can we do more?

Osteoporosis is common in older adults, with devastating personal and societal effects, most commonly after hip fracture. Many comorbidities are associated with an increased fracture risk, with Parkinson’s disease, the second commonest neurodegenerative condition, strongly associated with fractures. Individuals with dementia have been identified as having poor outcomes after fracture. Multimorbidity, generally recognised as the presence of two or more comorbidities, is common as we age and can represent a challenge to successful aging. One example of this is the common co-existence of dementia with Parkinson’s disease; this intersection can be especially harmful to bone health and fracture management in this group and makes appropriate preventative strategies critical to prevent the devastating consequences of hip fracture, especially given the poor outcomes after hip fracture among patients with dementia more generally. New techniques using machine learning may support best practice, though knowledge of how best to incorporate these technologies into international guidelines remains an urgent priority. Overall, clinicians, Parkinson’s disease patients and their carers should be proactive in their approach to bone health to reduce the risk of devastating fragility fracture.