Limits...
Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study.

van der Jagt-Willems HC, de Groot MH, van Campen JP, Lamoth CJ, Lems WF - BMC Geriatr (2015)

Bottom Line: An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51).A flexed posture was not significantly associated with future falls.We suggest clinical attention for underlying causes.

View Article: PubMed Central - PubMed

Affiliation: Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. hannavanderjagt@hotmail.com.

ABSTRACT

Background: Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/or flexed posture with future fall incidents in older adults within the next year.

Methods: Patients were recruited at a geriatric outpatient clinic. Vertebral fractures were evaluated on lateral radiographs of the spine with the semi-quantitative method of Genant; the degree of thoracic kyphosis was assessed with the Cobb angle. The occiput-to-wall distance was used to determine a flexed posture. Self-reported falls were prospectively registered by monthly phone contact for the duration of 12 months.

Results: Fifty-one older adults were included; mean age was 79 years (SD = 4.8). An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51). Prevalent vertebral fractures had a trend towards significancy (OR 3.67; 95% CI 0.85-15.9). A flexed posture was not significantly associated with future falls.

Conclusion: Older adults with an increased thoracic kyphosis are more likely to fall within the next year. We suggest clinical attention for underlying causes. Because patients with increased thoracic curvature of the spine might have underlying osteoporotic vertebral fractures, clinicians should be aware of the risk of a new fracture.

No MeSH data available.


Related in: MedlinePlus

Illustration of the distribution of patients in the study according to the presence of vertebral fractures, hyperkyphosis and flexed posture in relation to future falls. The large white rectangle represents all patients in the study (n = 51), whereof in the blue rectangle patients with vertebral fractures (n = 20; 39%); in the grey rectangle patients with a hyperkyphosis (Cobb angle ≥50 °; n = 28; 55%); and in the pink rectangle patients with a flexed posture (OWD >5.0 cm; n = 22; 44%). Patients with combinations of these entities are represented by the overlapping areas of the colored rectangles, with n noted in each box. Twelve patients (24%) had none of the entities present (white rectangle). * 9 patients had all entities present. ** The red oval represents all fallers (n = 13); all fallers had at least one of the three entities present. In nine fallers all entities were present.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4414293&req=5

Fig2: Illustration of the distribution of patients in the study according to the presence of vertebral fractures, hyperkyphosis and flexed posture in relation to future falls. The large white rectangle represents all patients in the study (n = 51), whereof in the blue rectangle patients with vertebral fractures (n = 20; 39%); in the grey rectangle patients with a hyperkyphosis (Cobb angle ≥50 °; n = 28; 55%); and in the pink rectangle patients with a flexed posture (OWD >5.0 cm; n = 22; 44%). Patients with combinations of these entities are represented by the overlapping areas of the colored rectangles, with n noted in each box. Twelve patients (24%) had none of the entities present (white rectangle). * 9 patients had all entities present. ** The red oval represents all fallers (n = 13); all fallers had at least one of the three entities present. In nine fallers all entities were present.

Mentions: Figure 2 shows the distribution of vertebral fractures, hyperkyphosis (Cobb angle ≥50°), and flexed posture (OWD >5.0 cm) in the study population. Twelve patients had (24%) none of the three entities. Nine patients (18%) were diagnosed with all three entities. The remaining thirty patients (59%) had one, or a combination of the entities.Figure 2


Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study.

van der Jagt-Willems HC, de Groot MH, van Campen JP, Lamoth CJ, Lems WF - BMC Geriatr (2015)

Illustration of the distribution of patients in the study according to the presence of vertebral fractures, hyperkyphosis and flexed posture in relation to future falls. The large white rectangle represents all patients in the study (n = 51), whereof in the blue rectangle patients with vertebral fractures (n = 20; 39%); in the grey rectangle patients with a hyperkyphosis (Cobb angle ≥50 °; n = 28; 55%); and in the pink rectangle patients with a flexed posture (OWD >5.0 cm; n = 22; 44%). Patients with combinations of these entities are represented by the overlapping areas of the colored rectangles, with n noted in each box. Twelve patients (24%) had none of the entities present (white rectangle). * 9 patients had all entities present. ** The red oval represents all fallers (n = 13); all fallers had at least one of the three entities present. In nine fallers all entities were present.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4414293&req=5

Fig2: Illustration of the distribution of patients in the study according to the presence of vertebral fractures, hyperkyphosis and flexed posture in relation to future falls. The large white rectangle represents all patients in the study (n = 51), whereof in the blue rectangle patients with vertebral fractures (n = 20; 39%); in the grey rectangle patients with a hyperkyphosis (Cobb angle ≥50 °; n = 28; 55%); and in the pink rectangle patients with a flexed posture (OWD >5.0 cm; n = 22; 44%). Patients with combinations of these entities are represented by the overlapping areas of the colored rectangles, with n noted in each box. Twelve patients (24%) had none of the entities present (white rectangle). * 9 patients had all entities present. ** The red oval represents all fallers (n = 13); all fallers had at least one of the three entities present. In nine fallers all entities were present.
Mentions: Figure 2 shows the distribution of vertebral fractures, hyperkyphosis (Cobb angle ≥50°), and flexed posture (OWD >5.0 cm) in the study population. Twelve patients had (24%) none of the three entities. Nine patients (18%) were diagnosed with all three entities. The remaining thirty patients (59%) had one, or a combination of the entities.Figure 2

Bottom Line: An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51).A flexed posture was not significantly associated with future falls.We suggest clinical attention for underlying causes.

View Article: PubMed Central - PubMed

Affiliation: Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. hannavanderjagt@hotmail.com.

ABSTRACT

Background: Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/or flexed posture with future fall incidents in older adults within the next year.

Methods: Patients were recruited at a geriatric outpatient clinic. Vertebral fractures were evaluated on lateral radiographs of the spine with the semi-quantitative method of Genant; the degree of thoracic kyphosis was assessed with the Cobb angle. The occiput-to-wall distance was used to determine a flexed posture. Self-reported falls were prospectively registered by monthly phone contact for the duration of 12 months.

Results: Fifty-one older adults were included; mean age was 79 years (SD = 4.8). An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51). Prevalent vertebral fractures had a trend towards significancy (OR 3.67; 95% CI 0.85-15.9). A flexed posture was not significantly associated with future falls.

Conclusion: Older adults with an increased thoracic kyphosis are more likely to fall within the next year. We suggest clinical attention for underlying causes. Because patients with increased thoracic curvature of the spine might have underlying osteoporotic vertebral fractures, clinicians should be aware of the risk of a new fracture.

No MeSH data available.


Related in: MedlinePlus