{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:13:15Z","timestamp":1792793595860,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR302394"],"award-info":[{"award-number":["NIHR302394"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000324","name":"GATSBY","doi-asserted-by":"publisher","award":["GAT3676"],"award-info":[{"award-number":["GAT3676"]}],"id":[{"id":"10.13039\/501100000324","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Royal Osteoporosis Society (509) Parkinson\u2019s Excellence Network","award":["M-22-004"],"award-info":[{"award-number":["M-22-004"]}],"id":[{"id":"https:\/\/ror.org\/04mm5g824","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Parkinson\u2019s disease (PD), the propensity to fall and the higher risk of osteoporosis converge yielding a high fracture risk. Updated National Osteoporosis Guideline Group (NOGG) guidance recommends that PD should trigger a risk assessment, for example using the FRAX tool, yet clinical pathways remain sub-optimal. To address this, we generated an algorithm for the assessment and management of bone health specifically in PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Within the Proactive and Integrated Management and Empowerment in Parkinson\u2019s Disease randomised controlled trial (PRIME-UK RCT), bone-health metrics were collected, and all participants were offered a dual X-ray absorptiometry scan. The FRAX tool was used to obtain the 10-year probability of hip and major osteoporotic fracture (MOF), and the resulting NOGG risk-category recorded. Probabilities were recalculated including femoral-neck bone mineral density (FN-BMD) and\/or with numeric adjustment for recurrent falls, and results compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 182 people with parkinsonism (mean age 73.8\u00a0years, 65% male, median disease duration 5 years), 28% reported a prior fragility fracture, and 40.7% recurrent falls over the previous year. 28.6% had MOF above NOGG intervention thresholds (IT); whilst 12.1% had a FN-BMD T-Score\u2009\u2264\u2009\u22122.5. Recalculation of FRAX with FN-BMD (n\u2009=\u2009182) reduced fracture MOF and hip fracture probabilities; 12 (6.6%) deescalated below the IT, and 16 (8.8%) moved above the IT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This 2024 BONE-PARK algorithm is informed by both the latest NOGG Guidelines and novel findings in a \u2018real-world\u2019 population. The algorithm will aid bone health assessment for people with PD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afaf052","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T07:15:38Z","timestamp":1740554138000},"source":"Crossref","is-referenced-by-count":17,"title":["Assessing and managing bone health and fracture risk in Parkinson\u2019s disease: the BONE PARK 2 protocol"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6659-5180","authenticated-orcid":false,"given":"Katie C","family":"Naylor","sequence":"first","affiliation":[{"name":"Ageing and Movement Research Group , Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 2PS ,","place":["UK"]},{"name":"University of Bristol , Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 2PS 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,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0930-7124","authenticated-orcid":false,"given":"Veronica","family":"Lyell","sequence":"additional","affiliation":[{"name":"Older People's Unit, Royal United Hospitals Bath NHS Foundation Trust, \u00a0 Bath, BA1 3NG ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6414-0529","authenticated-orcid":false,"given":"Celia L","family":"Gregson","sequence":"additional","affiliation":[{"name":"Older People's Unit, Royal United Hospitals Bath NHS Foundation Trust, \u00a0 Bath, BA1 3NG ,","place":["UK"]},{"name":"Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, BS10 5NB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0016-1870","authenticated-orcid":false,"given":"Emily 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