Association between care rehabilitation and the risk of fracture hospitalization in people with Parkinson's disease

Aim This study examined whether there is an association between continuous care rehabilitation (CR) and the risk of fracture hospitalization among people with Parkinson's disease (PwP) aged >75 years with mild-to-moderate care needs level. Methods A retrospective study design based on the merging of medical claims and long-term care insurance claims data was used. Before propensity score matching, of the 2177 participants, 222 received continuous CR, whereas 1955 did not. After matching using a 1:4 ratio, we identified 222 patients in the CR group and 888 patients in the non-CR groups. We carried out a survival analysis to clarify the association between CR and the risk of fracture hospitalization. Results After matching, there was a significant difference between the CR and non-CR groups in 3 years (stratified log-rank test by age P = 0.036) and in 4 years (stratified log-rank test by age P = 0.011). The CR group was significantly associated with delays of hospital admission due to fracture within 3 years (hazard ratio 0.54; 95% confidence interval 0.29-0.99; P = 0.047) and within 4 years (hazard ratio 0.52; 95% confidence interval 0.30-0.88; P = 0.010). Conclusions Our study showed that older people with Parkinson's disease who continuously received CR had a lower risk of fracture hospitalization in 3 and 4 years than those who did not receive CR or received interrupted CR. Considering our participants with a mild-to-moderate care needs level, a sustainable CR service might benefit people with Parkinson's disease from an early time when their activities of daily living are still intact and cognitive function has not deteriorated. Geriatr Gerontol Int 2022; center dot center dot: center dot center dot-center dot center dot.