Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.

Low muscle strength has been found in late adolescence in individuals diagnosed with Parkinson disease (PD) 30 y later. This study investigated whether this lower muscle strength also may translate into increased risks of falling and fracture before the diagnosis of PD.Among all Swedish citizens age...

Full description

Bibliographic Details
Main Authors: Helena Nyström, Anna Nordström, Peter Nordström
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-02-01
Series:PLoS Medicine
Online Access:http://europepmc.org/articles/PMC4737490?pdf=render
_version_ 1819082869498183680
author Helena Nyström
Anna Nordström
Peter Nordström
author_facet Helena Nyström
Anna Nordström
Peter Nordström
author_sort Helena Nyström
collection DOAJ
description Low muscle strength has been found in late adolescence in individuals diagnosed with Parkinson disease (PD) 30 y later. This study investigated whether this lower muscle strength also may translate into increased risks of falling and fracture before the diagnosis of PD.Among all Swedish citizens aged ≥50 y in 2005, two nested case-control cohorts were compiled. In cohort I, individuals diagnosed with PD during 1988-2012 (n = 24,412) were matched with up to ten controls (n = 243,363), and the risk of fall-related injuries before diagnosis of PD was evaluated. In cohort II, individuals with an injurious fall in need of emergency care during 1988-2012 (n = 622,333) were matched with one control (n = 622,333), and the risk of PD after the injurious fall was evaluated. In cohort I, 18.0% of cases and 11.5% of controls had at least one injurious fall (p < 0.001) prior to PD diagnosis in the case. Assessed by conditional logistic regression analysis adjusted for comorbid diagnoses and education level, PD was associated with increased risks of injurious fall up to 10 y before diagnosis (odds ratio [OR] 1.19, 95% CI 1.08-1.31; 7 to <10 y before diagnosis) and hip fracture ≥15 y before diagnosis (OR 1.36, 95% CI 1.10-1.69; 15-26 y before diagnosis). In cohort II, 0.7% of individuals with an injurious fall and 0.5% of controls were diagnosed with PD during follow-up (p < 0.001). The risk of PD was increased for up to 10 y after an injurious fall (OR 1.18, 95% CI 1.02-1.37; 7 to <10 y after diagnosis). An important limitation is that the diagnoses were obtained from registers and could not be clinically confirmed for the study.The increased risks of falling and hip fracture prior to the diagnosis of PD may suggest the presence of clinically relevant neurodegenerative impairment many years before the diagnosis of this disease.
first_indexed 2024-12-21T20:23:32Z
format Article
id doaj.art-d5dd765201b848b99b416d5461454cc8
institution Directory Open Access Journal
issn 1549-1277
1549-1676
language English
last_indexed 2024-12-21T20:23:32Z
publishDate 2016-02-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS Medicine
spelling doaj.art-d5dd765201b848b99b416d5461454cc82022-12-21T18:51:26ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762016-02-01132e100195410.1371/journal.pmed.1001954Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.Helena NyströmAnna NordströmPeter NordströmLow muscle strength has been found in late adolescence in individuals diagnosed with Parkinson disease (PD) 30 y later. This study investigated whether this lower muscle strength also may translate into increased risks of falling and fracture before the diagnosis of PD.Among all Swedish citizens aged ≥50 y in 2005, two nested case-control cohorts were compiled. In cohort I, individuals diagnosed with PD during 1988-2012 (n = 24,412) were matched with up to ten controls (n = 243,363), and the risk of fall-related injuries before diagnosis of PD was evaluated. In cohort II, individuals with an injurious fall in need of emergency care during 1988-2012 (n = 622,333) were matched with one control (n = 622,333), and the risk of PD after the injurious fall was evaluated. In cohort I, 18.0% of cases and 11.5% of controls had at least one injurious fall (p < 0.001) prior to PD diagnosis in the case. Assessed by conditional logistic regression analysis adjusted for comorbid diagnoses and education level, PD was associated with increased risks of injurious fall up to 10 y before diagnosis (odds ratio [OR] 1.19, 95% CI 1.08-1.31; 7 to <10 y before diagnosis) and hip fracture ≥15 y before diagnosis (OR 1.36, 95% CI 1.10-1.69; 15-26 y before diagnosis). In cohort II, 0.7% of individuals with an injurious fall and 0.5% of controls were diagnosed with PD during follow-up (p < 0.001). The risk of PD was increased for up to 10 y after an injurious fall (OR 1.18, 95% CI 1.02-1.37; 7 to <10 y after diagnosis). An important limitation is that the diagnoses were obtained from registers and could not be clinically confirmed for the study.The increased risks of falling and hip fracture prior to the diagnosis of PD may suggest the presence of clinically relevant neurodegenerative impairment many years before the diagnosis of this disease.http://europepmc.org/articles/PMC4737490?pdf=render
spellingShingle Helena Nyström
Anna Nordström
Peter Nordström
Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.
PLoS Medicine
title Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.
title_full Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.
title_fullStr Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.
title_full_unstemmed Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.
title_short Risk of Injurious Fall and Hip Fracture up to 26 y before the Diagnosis of Parkinson Disease: Nested Case-Control Studies in a Nationwide Cohort.
title_sort risk of injurious fall and hip fracture up to 26 y before the diagnosis of parkinson disease nested case control studies in a nationwide cohort
url http://europepmc.org/articles/PMC4737490?pdf=render
work_keys_str_mv AT helenanystrom riskofinjuriousfallandhipfractureupto26ybeforethediagnosisofparkinsondiseasenestedcasecontrolstudiesinanationwidecohort
AT annanordstrom riskofinjuriousfallandhipfractureupto26ybeforethediagnosisofparkinsondiseasenestedcasecontrolstudiesinanationwidecohort
AT peternordstrom riskofinjuriousfallandhipfractureupto26ybeforethediagnosisofparkinsondiseasenestedcasecontrolstudiesinanationwidecohort