Are stroke patients at a higher risk of bone fractures?

This meta-analysis aimed to determine whether stroke patients experience fractures more commonly than non-stroke patients. The authors concluded that stroke is associated with an increased risk of fractures.  

Stroke patients commonly have post-stroke physical and mental disabilities which can affect their health, independence and quality of life. These disabilities contribute to low bone mineral density and more falls. Previous studies have found an increased risk of fractures in stroke patients. It is unclear whether this is due to the stroke or due to age or other health problems commonly seen in stroke patients. Better understanding of this would allow for more effective screening, prevention and treatment of bone fractures in stroke patients.

The authors compiled data from the Ontario stroke database. This included 23751 stroke patients and 11240 transient ischemic attacks (TIA, temporary blockage of blood flow to the brain) patients. 23751 healthy patients with similar ages as the stroke patients were also included. The risk of fractures were compared. 

The 2 year fracture risk was 32% greater in stroke patients compared to TIA patients and 47% greater than healthy controls.

Risk of falls were similar in stroke and TIA patients. The risk of falls in stroke patients was 60% higher compared to healthy controls.

There were a number of factors that increased the risk of fractures. These include older age, female sex, stroke severity, prior stroke, osteoporosis, arthritis, hyperparathyroidism (low calcium levels) and artrial fibrillation (irregular heart rhythm).

The authors concluded that stroke is associated with a higher risk of fractures.