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Age-related hyperkyphosis, independent of spinal osteoporosis, is associated with impaired mobility in older community-dwelling women.

Katzman WB, Vittinghoff E, Kado DM - Osteoporos Int (2010)

Bottom Line: Using multivariate linear regression, we estimated the independent association of kyphosis with mobility time, and quantified effects of other covariates on mobility.Longer performance times were significantly associated with increasing age, decreasing grip strength, vertebral fractures, body mass index ≥25, and total hip BMD in the osteoporotic range.Hyperkyphosis may be a useful clinical marker signaling the need for evaluation of vertebral fracture and falling risk.

View Article: PubMed Central - PubMed

Affiliation: University of California, San Francisco, UCSF Box 0625, San Francisco, CA 94143-0625, USA.wendy.katzman@ucsfmedctr.org

ABSTRACT

Unlabelled: While many assume hyperkyphosis reflects underlying spinal osteoporosis and vertebral fractures, our results suggest hyperkyphosis is independently associated with decreased mobility. Hyperyphosis is associated with slower Timed Up and Go performance times and may be a useful clinical marker signaling the need for evaluation of vertebral fracture and falling risk.

Introduction: While multiple studies have demonstrated negative effects of hyperkyphosis on physical function, none have disentangled the relationship between hyperkyphosis, impaired function, and underlying spinal osteoporosis. The purpose of this study is to determine whether kyphosis, independent of spinal osteoporosis, is associated with mobility on the Timed Up and Go, and to quantify effects of other factors contributing to impaired mobility.

Methods: We used data for 3,108 community-dwelling women aged 55-80 years in the Fracture Intervention Trial. All participants had measurements of kyphosis, mobility time on the Timed Up and Go test, height, weight, total hip bone mineral density (BMD), grip strength, and vertebral fractures at baseline visits in 1993. Demographic characteristics included age and smoking status. We calculated mean Timed Up and Go time by quartile of kyphosis. Using multivariate linear regression, we estimated the independent association of kyphosis with mobility time, and quantified effects of other covariates on mobility.

Results: Mean mobility time increased from 9.3 s in the lowest to 10.1 s in the highest quartile of kyphosis. In a multivariate-adjusted model, mobility time increased 0.11 s (p = 0.02) for each standard deviation (11.9°) increase in kyphosis. Longer performance times were significantly associated with increasing age, decreasing grip strength, vertebral fractures, body mass index ≥25, and total hip BMD in the osteoporotic range.

Conclusions: Kyphosis angle is independently associated with decreased mobility on the Timed Up and Go, which is in turn correlated with increased fall risk. Hyperkyphosis may be a useful clinical marker signaling the need for evaluation of vertebral fracture and falling risk.

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Related in: MedlinePlus

Timed Up and Go (s) by Quartile of Kyphosis (°) (min-max)
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Fig1: Timed Up and Go (s) by Quartile of Kyphosis (°) (min-max)

Mentions: Women were an average of 68.2 years old, and ranged from 55 to 81 years old (Table 1). All were independently living, ambulatory, and 95% rated their health as good to excellent. Mean (SD) kyphosis angle was 47.6 (11.9)° (range 3-83°), and was associated with increasing age, higher body mass index, lower total hip BMD, lower grip strength, and history of vertebral fracture. Mean (SD) performance on the Timed Up and Go was 9.7 (2.7) s (range 5--91 s). Figure 1 shows mean performance times by quartile of kyphosis angle. In a model adjusting only for age, the increase in average performance time for each standard deviation (11.9°) increase in kyphosis angle was 0.2 s (p < 0.001). The association between kyphosis and longer times was attenuated but remained statistically significant after controlling for age, smoking status, body mass index, total BMD of the hip, grip strength, and number of vertebral fractures (Table 2). Longer performance times were also strongly associated with increasing age and decreasing grip strength; in addition, there was weak evidence for reduced mobility among current smokers and women with vertebral fractures. Compared to women with normal BMI, average performance times were longer among women in the overweight and obese categories. Mobility was also reduced among women with total hip BMD in the osteoporotic range, as compared to women with normal hip BMD.Table 1


Age-related hyperkyphosis, independent of spinal osteoporosis, is associated with impaired mobility in older community-dwelling women.

Katzman WB, Vittinghoff E, Kado DM - Osteoporos Int (2010)

Timed Up and Go (s) by Quartile of Kyphosis (°) (min-max)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2958231&req=5

Fig1: Timed Up and Go (s) by Quartile of Kyphosis (°) (min-max)
Mentions: Women were an average of 68.2 years old, and ranged from 55 to 81 years old (Table 1). All were independently living, ambulatory, and 95% rated their health as good to excellent. Mean (SD) kyphosis angle was 47.6 (11.9)° (range 3-83°), and was associated with increasing age, higher body mass index, lower total hip BMD, lower grip strength, and history of vertebral fracture. Mean (SD) performance on the Timed Up and Go was 9.7 (2.7) s (range 5--91 s). Figure 1 shows mean performance times by quartile of kyphosis angle. In a model adjusting only for age, the increase in average performance time for each standard deviation (11.9°) increase in kyphosis angle was 0.2 s (p < 0.001). The association between kyphosis and longer times was attenuated but remained statistically significant after controlling for age, smoking status, body mass index, total BMD of the hip, grip strength, and number of vertebral fractures (Table 2). Longer performance times were also strongly associated with increasing age and decreasing grip strength; in addition, there was weak evidence for reduced mobility among current smokers and women with vertebral fractures. Compared to women with normal BMI, average performance times were longer among women in the overweight and obese categories. Mobility was also reduced among women with total hip BMD in the osteoporotic range, as compared to women with normal hip BMD.Table 1

Bottom Line: Using multivariate linear regression, we estimated the independent association of kyphosis with mobility time, and quantified effects of other covariates on mobility.Longer performance times were significantly associated with increasing age, decreasing grip strength, vertebral fractures, body mass index ≥25, and total hip BMD in the osteoporotic range.Hyperkyphosis may be a useful clinical marker signaling the need for evaluation of vertebral fracture and falling risk.

View Article: PubMed Central - PubMed

Affiliation: University of California, San Francisco, UCSF Box 0625, San Francisco, CA 94143-0625, USA.wendy.katzman@ucsfmedctr.org

ABSTRACT

Unlabelled: While many assume hyperkyphosis reflects underlying spinal osteoporosis and vertebral fractures, our results suggest hyperkyphosis is independently associated with decreased mobility. Hyperyphosis is associated with slower Timed Up and Go performance times and may be a useful clinical marker signaling the need for evaluation of vertebral fracture and falling risk.

Introduction: While multiple studies have demonstrated negative effects of hyperkyphosis on physical function, none have disentangled the relationship between hyperkyphosis, impaired function, and underlying spinal osteoporosis. The purpose of this study is to determine whether kyphosis, independent of spinal osteoporosis, is associated with mobility on the Timed Up and Go, and to quantify effects of other factors contributing to impaired mobility.

Methods: We used data for 3,108 community-dwelling women aged 55-80 years in the Fracture Intervention Trial. All participants had measurements of kyphosis, mobility time on the Timed Up and Go test, height, weight, total hip bone mineral density (BMD), grip strength, and vertebral fractures at baseline visits in 1993. Demographic characteristics included age and smoking status. We calculated mean Timed Up and Go time by quartile of kyphosis. Using multivariate linear regression, we estimated the independent association of kyphosis with mobility time, and quantified effects of other covariates on mobility.

Results: Mean mobility time increased from 9.3 s in the lowest to 10.1 s in the highest quartile of kyphosis. In a multivariate-adjusted model, mobility time increased 0.11 s (p = 0.02) for each standard deviation (11.9°) increase in kyphosis. Longer performance times were significantly associated with increasing age, decreasing grip strength, vertebral fractures, body mass index ≥25, and total hip BMD in the osteoporotic range.

Conclusions: Kyphosis angle is independently associated with decreased mobility on the Timed Up and Go, which is in turn correlated with increased fall risk. Hyperkyphosis may be a useful clinical marker signaling the need for evaluation of vertebral fracture and falling risk.

Show MeSH
Related in: MedlinePlus