People with Parkinson’s have a higher risk of fracturing a bone than the general population, so it’s especially important to look after your bone health. We learn more with Professor Donald Grosset.
- Bone health is important for everyone, but especially if you have Parkinson's.
- You are at more risk of getting osteoporosis when you have Parkinson's, which can weaken bones and make them more likely to break.
- Your healthcare team can assess you and may prescribe medication to help improve your bone health.
- Strength exercises and maintaining a good diet can also help.
What is bone health?
Bone health really means having ‘healthy bones’. Healthy bones are strong enough to prevent fractures, for example when we have a fall. Our bones are more healthy when we have enough calcium in our diet (from milk, and dairy products like cheese) and when we use our arms and legs (such as with exercise).
Both women and men need to make sure that they do the right things to keep their bones healthy.
Why is bone health so important if you have Parkinson’s?
Bone health is important for everyone, but especially if you have Parkinson's. This is for lots of reasons.
Osteoporosis is a condition that affects the bones, causing them to become weak and fragile and more likely to break. It’s often diagnosed in people with Parkinson’s.
The absorption of important nutrients like calcium is reduced if you have Parkinson’s. This can result in thinner bones that increases the risk of a fracture.
Loss of balance and falling affects many people with Parkinson’s. If your bone health is poor, a fall could lead to a broken bone.
Women are generally more likely to have ‘thinner’ bones than men, and bones become thinner as we get older. But men who have Parkinson’s may also develop thinning bones. So both women and men need to make sure that they do the right things to keep their bones healthy.
How does someone know how good their bone health is?
A number of different factors can help to work out what your risk of poor bone health is. These are combined in a ‘risk calculator’ that works out your future chance of having a bone fracture (usually over the next 10 years). Your specialist, Parkinson’s nurse or GP can calculate your risk score. The Royal Osteoporosis Society also has a risk checker you can use.
When the risk is high, there are treatments that help to thicken bones and prevent fractures.
When you're at medium risk, you may be sent for a bone scan, also called a DEXA scan. This takes a scan of your bone density and can help decide if any treatment is needed.
When the risk is low, medication is not needed, but you should try to protect your bone health. See below for ways you can do this.
Vitamin D helps to keep your bones healthy and helps your body absorb calcium. Most of the vitamin D you need comes from the effect of sunlight on your skin but what you eat can also help.
What can someone do to look after their bone health?
If we become inactive our bones get thinner, which increases the risks of having a fracture. Physical activity and exercise is good for bone health, as well as helping you manage your Parkinson’s symptoms.
Diet is also very important, particularly calcium. Sources of calcium include milk and dairy products like cheese. Try to aim for 3 servings of milk or dairy foods every day to get the calcium you need.
Vitamin D helps to keep your bones healthy and helps your body absorb calcium. Most of the vitamin D you need comes from the effect of sunlight on your skin but what you eat can also help, especially during the winter. Good sources of vitamin D include oily fish (such as salmon and mackerel), red meat and eggs.
Is medication an option if you have poor bone health?
Medication can improve bone health, when the risk of bone fracture is high, or if there is evidence of osteoporosis on a bone density scan.
Supplements like Vitamin D and calcium can help to strengthen bones. If someone is at higher risk, your doctor may also prescribe medication, which can make more calcium enter bones and help make them stronger.
In some people, a mixture of these treatments is helpful. In other people, a supplement is enough to improve bone health.
Like any medication, there are benefits and risks to taking a drug to improve bone health. Speak to your health professional to discuss whether they might be helpful for you to take to prevent or lower the risk of poor bone health.
Alison was diagnosed with Parkinson’s in 2012 and lives in Edinburgh.
"I’d heard that bone health was an issue for people with Parkinson’s. When I spoke to my GP to ask if I was at risk, he reassured me that I would likely be fine. But I knew there was a simple assessment to check – so I insisted I had
"I’m glad I did, as it showed that I was at risk, and I was put on medication. I believe thiswasn’t just preventative, but life-enhancing. Knowing that my bone health was being ‘looked after’ gave me the confidence to go sledging this year when we had lots of snow. It was terrific fun.”
Elaine lives in Wales and was diagnosed with Parkinson’s in 2000.
"Six years ago I was referred to a consultant because of pain in my knee. After having bone scans they told me my bones were thinning and I was diagnosed with osteoporosis.
"I am now getting treatment for osteoporosis and receive Zoledronic Acid infusion yearly (an osteoporosis medication to help strengthen your bones and reduce your risk of breaking a bone). I also take 2 caplets daily of Adcal-D3, which provide extra calcium and vitamin D3 in my diet.
"I have not broken any bones and I feel that I am very fortunate that I was diagnosed before receiving any fractures. I think everyone who is diagnosed with Parkinson’s should be made aware of the relationship between Parkinson’s and osteoporosis.”
Bone health Q&A
Watch our Associate Director of the Excellence Network, Rowan Wathes and a panel of experts, including Professor Donald Grosset and Sarah Leyland, an osteoporosis specialist nurse, answer your questions about bone health.