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. 2022 Mar 31;12(3):e052421.
doi: 10.1136/bmjopen-2021-052421.

Association of kyphotic posture with loss of independence and mortality in a community-based prospective cohort study: the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS)

Yasukazu Hijikata  1 , Tsukasa Kamitani  1 , Miho Sekiguchi  2 , Koji Otani  2 , Shin-Ichi Konno  2 , Misa Takegami  3 , Shunichi Fukuhara  4   5 , Yosuke Yamamoto  6
Affiliations

Association of kyphotic posture with loss of independence and mortality in a community-based prospective cohort study: the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS)

Yasukazu Hijikata et al. BMJ Open. .

Abstract

Objectives: This study aimed to investigate the association between kyphotic posture and future loss of independence (LOI) and mortality in community-dwelling older adults.

Design: Prospective cohort study.

Setting: Two Japanese municipalities.

Participants: We enrolled 2193 independent community-dwelling older adults aged≥65 years at the time of their baseline health check-up in 2008. Kyphotic posture was evaluated using the wall-occiput test (WOT) and classified into three categories: non-kyphotic, mild (>0 and ≤4 cm) and severe (>4 cm).

Primary and secondary outcome measures: The primary outcome was mortality and the secondary outcomes were LOI (new long-term care insurance certification levels 1-5) and a composite of LOI and mortality. A Cox proportional hazards model was used to estimate the adjusted HRs (aHRs).

Results: Of the 2193 subjects enrolled, 1621 were included in the primary analysis. Among these, 272 (17%) and 202 (12%) were diagnosed with mild and severe kyphotic postures, respectively. The median follow-up time was 5.8 years. Compared with the non-kyphotic group, the aHRs for mortality were 1.17 (95% CI 0.70 to 1.96) and 1.99 (95% CI 1.20 to 3.30) in the mild and severe kyphotic posture groups, respectively. In the secondary analysis, a consistent association was observed for LOI (mild: aHR 1.70, 95% CI 1.13 to 2.55; severe: aHR 2.08, 95% CI 1.39 to 3.10) and the LOI-mortality composite (mild: aHR 1.27, 95% CI 0.90 to 1.79; severe: aHR 1.83, 95% CI 1.31 to 2.56).

Conclusion: Kyphotic posture was associated with LOI and mortality in community-dwelling older adults. Identifying the population with kyphotic posture using the WOT might help improve community health.

Keywords: geriatric medicine; musculoskeletal disorders; public health; spine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram of eligible participants. LOHAS, Locomotive Syndrome and Health Outcomes in Aizu Cohort Study; WOT, wall-occiput test.
Figure 2
Figure 2
Cumulative incidence of mortality. Subjects were divided into the following three groups according to the degree of kyphotic posture: none, mild (>0, ≤4 cm) and severe (>4 cm). The p value was calculated using log-rank test.
Figure 3
Figure 3
Cause-specific deaths in each group. Participants were divided into the following three groups according to the degree of kyphosis: none, mild (>0, ≤4 cm) and severe (>4 cm).
See this image and copyright information in PMC

References

    1. Schwab F, Lafage V, Boyce R. Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position. Spine 2006;31:959–67. 10.1097/01.brs.0000248126.96737.0f - DOI - PubMed
    1. Farcy JP, Schwab FJ. Management of flatback and related kyphotic decompensation syndromes. Spine 1997;22:2452–7. 10.1097/00007632-199710150-00025 - DOI - PubMed
    1. Ailon T, Shaffrey CI, Lenke LG, et al. . Progressive spinal kyphosis in the aging population. Neurosurgery 2015;77 Suppl 4:S164–72. 10.1227/NEU.0000000000000944 - DOI - PubMed
    1. Kado DM, Prenovost K, Crandall C. Narrative review: hyperkyphosis in older persons. Ann Intern Med 2007;147:330–8. 10.7326/0003-4819-147-5-200709040-00008 - DOI - PubMed
    1. Eum R, Leveille SG, Kiely DK, et al. . Is kyphosis related to mobility, balance, and disability? Am J Phys Med Rehabil 2013;92:980–9. 10.1097/PHM.0b013e31829233ee - DOI - PMC - PubMed