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    Bone mineral density and serum vitamin d status in parkinson's disease: Are the stage and clinical features of the disease Important?
    (Wolters Kluwer Medknow Publications, 2020) Öztürk, Erhan Arif; Gündoğdu, İbrahim; Tonuk, Burak; Umay, Ebru; Koçer, Bilge Gönenli; Çakcı, Aytül
    Background: Although it is well known that patients with Parkinson's disease (PD) have low bone mineral density (BMD) and serum vitamin D level, there are no studies evaluating their relationship with the stage and clinical features of the PD. Objective: The purpose of this study was to evaluate the relationship between BMD and serum vitamin D level and stage or clinical features of the PD. Materials and Methods: One hundred twenty-four patients with PD recruited from Movement Disorders Outpatient Clinic and age- and sex-matched 116 healthy controls were included in the study. BMD and serum vitamin D level of all participants were measured. After patients had been divided into four groups according to Hoehn and Yahr (H and Y) staging, a total of 5 groups with controls, BMD (lumbar and femoral) and serum vitamin D level were compared between groups. The relationship between the clinical features of the PD [disease duration, medication history, Unified Parkinson's Disease Rating Scale (UPDRS) part II and III, and subscores of UPDRS part III] and BMD or vitamin D was investigated. Results: Lumbar and femoral BMD values and serum vitamin D level were significantly lower in patients with PD compared to controls. Low BMD and low serum vitamin D level were identified in the early stages of the disease (H and Y stage 1 and 1.5) and were marked by the progress of the stage of the disease. There was a negative relationship between the clinical features of the PD and both BMD and serum vitamin D level. Conclusion: All patients with PD should be screened for developing osteoporosis and for sufficient vitamin D level in the early stages of the disease. Preventive methods for bone quality should be taken into consideration at the onset of PD.
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    Decreased handgrip strength and increased hip osteoporosis in patients with Alzheimer's disease
    (Riyadh Armed Forces Hospital, 2007) Ayhan, Figen; Soyupek, Feray; Tonuk, Burak; Gökoğlu, Figen; Yorgancıoğlu, Rezan
    Objectives: To evaluate the causes of disability in the musculoskeletal system, and depression in patients with Alzheimer's disease (AD) and healthy controls. Methods: A case-controlled study in which healthy elderly patients (n=56) and patients with AD (n=75) attending the Geriatric Rehabilitation Unit of Ankara Education and Research Hospital, Department of Physical Medicine and Rehabilitation were compared on several measures of disability including handgrip strength, knee x-rays graded for osteoarthritis, dual-energy x-ray absorptiometry results for osteoporosis, and depression scores in the training period of 2003-2004. Results: Handgrip strength values were significantly lower in patients with AD compared to the controls (19.4 versus 37 pounds force). Osteoporosis in the femoral neck was also more prominent in patients with AD compared to controls (T-scores: -2.1 versus -1.2). Handgrip strength was moderately correlated with femoral neck T-scores (r=0.6, p=0.001). Conclusion: Strategies should be developed to protect patients with AD from osteoporosis and reduced muscle strength.