Effective Strategies for Managing Osteoporosis in Parkinson's Disease

Importance of Screening for Osteoporosis in Parkinson’s Patients

Osteoporosis screening is crucial for individuals with Parkinson’s disease due to their increased vulnerability to fractures. Studies indicate that approximately 60% of patients with PD fall annually, with many suffering from recurrent falls that can lead to severe injuries (Breasail et al., 2025). The Global Longitudinal Study of Osteoporosis in Women identified PD as a significant contributor to fracture risk, particularly in women, while research in the U.S. reported lower bone mineral density (BMD) and higher fracture rates in men with PD compared to their non-PD counterparts (Breasail et al., 2025).

Clinical Guidelines for Osteoporosis Treatment in Parkinson’s Disease

Current clinical practice guidelines emphasize the necessity of integrating osteoporosis management into the treatment protocols for PD. This includes routine assessments for fracture risk using validated tools like the FRAX score, which incorporates clinical risk factors alongside BMD measurements (Breasail et al., 2025). Despite the documented high fracture rates in PD, many healthcare providers do not consistently apply these guidelines, leading to gaps in care. For example, a recent systematic review found that only two out of six clinical practice guidelines specifically addressed osteoporosis in PD, indicating a significant need for comprehensive treatment algorithms tailored for this population.

The Role of Nutrition and Exercise in Bone Health for PwP

Nutrition

Nutritional status plays a pivotal role in maintaining bone health in individuals with Parkinson’s disease. Adequate intake of calcium and vitamin D is essential for preserving bone density. The guidelines recommend that healthcare providers promote dietary modifications to ensure sufficient intake of these nutrients (Breasail et al., 2025). Vitamin D supplementation is particularly emphasized, as it is crucial for calcium absorption and bone health. Furthermore, the importance of protein intake, which is essential for muscle strength and overall health in the elderly, should not be overlooked.

Exercise

Physical activity is another cornerstone of osteoporosis management in Parkinson’s disease. Engaging in regular weight-bearing and resistance exercises has been shown to enhance bone density and reduce fall risk in older adults (Breasail et al., 2025). The guidelines advocate for tailored exercise programs that focus on improving balance, strength, and coordination, which are essential for reducing the risk of falls and fractures.

Addressing Disparities in Osteoporosis Management for Parkinson’s Disease

Despite the high prevalence of osteoporosis and fractures in Parkinson’s disease, significant disparities exist in the management of bone health. Factors such as socioeconomic status, geographic location, and access to healthcare services can affect the availability and quality of osteoporosis treatment. Studies have demonstrated that individuals from lower socioeconomic backgrounds often have less access to preventive healthcare and osteoporosis management (Breasail et al., 2025). Addressing these disparities is essential to ensure that all patients with PD receive appropriate screening and treatment for osteoporosis.

Strategies to Address Disparities

• Community Education: Public health initiatives aimed at educating patients and caregivers about osteoporosis and its management in PD.
• Policy Advocacy: Advocating for policies that improve access to osteoporosis screening and treatment for underserved populations.
• Integrated Care Models: Developing integrated care pathways that connect patients with multidisciplinary teams, including nutritionists, physiotherapists, and geriatricians.

Conclusion

Managing osteoporosis in individuals with Parkinson’s disease is a multifaceted challenge that requires a comprehensive approach to screening, treatment, nutrition, and exercise. By adhering to clinical guidelines and addressing disparities in care, healthcare providers can significantly improve bone health outcomes for this vulnerable population. Ongoing education and policy initiatives will be vital in promoting equitable access to osteoporosis management and enhancing the quality of life for individuals living with Parkinson’s disease.

FAQ

What is the relationship between Parkinson’s disease and osteoporosis?

Parkinson’s disease increases the risk of osteoporosis due to reduced mobility, muscle weakness, and the effects of certain medications, leading to lower bone density and higher fracture rates.

How can nutritional interventions help manage osteoporosis in Parkinson’s patients?

Nutritional interventions, including adequate intake of calcium and vitamin D, can improve bone density and overall health in patients with Parkinson’s disease.

What type of exercises are beneficial for osteoporosis management in Parkinson’s disease?

Weight-bearing, resistance, and balance exercises are recommended to enhance bone density, improve muscle strength, and reduce the risk of falls.

Why is screening for osteoporosis important in Parkinson’s disease?

Screening for osteoporosis is crucial to identify individuals at risk of fractures early, allowing for timely intervention and management strategies to prevent serious injuries.

How can health disparities affect osteoporosis management in Parkinson’s disease?

Health disparities can limit access to osteoporosis screening and treatment, particularly for patients from lower socioeconomic backgrounds or those living in rural areas, leading to worse health outcomes.

References

1. Breasail, M. Ó., Singh, K. P., Lithander, F. E., Soh, S.-E., McConvey, V., McGinley, J., Morris, M. E., Ebeling, P. R., Zanker, J., & Zengin, A. (2025). Management of Osteoporosis in Parkinson’s Disease: A Systematic Review of Clinical Practice Guidelines. Movement Disorders Clinical Practice

2. NICE NG71. (2017). Parkinson’s disease in adults. National Institute for Health and Care Excellence

3. SIGN 142. (2020). Management of osteoporosis and the prevention of fragility fractures. Scottish Intercollegiate Guidelines Network

4. NOGG 2021. (2021). Clinical guideline for the prevention and treatment of osteoporosis. National Osteoporosis Guideline Group

5. Henderson, E. L., et al. (2019). Management of fracture risk in Parkinson’s: A revised algorithm and focused review of treatments. Journal of Neurology

6. Carroll, C. B., et al. (2020). Addressing Comorbidities in People with Parkinson’s Disease: Considerations from an Expert Panel. Parkinsonism and Related Disorders. https://doi.org/10.1016/j.parkreldis.2020.02.002

7. van der Marck, M. A., et al. (2014). Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson’s disease. Parkinsonism and Related Disorders. https://doi.org/10.1016/j.parkreldis.2013.12.009