title: Thoracic kyphosis and ventilatory dysfunction in unselected older persons: an epidemiological study in Dicomano, Italy.
abstract: OBJECTIVE
  To assess whether kyphosis is associated with ventilatory dysfunction in older community dwellers.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The unselected population of Dicomano, Italy aged>or=65 years.
  
  
  METHODS
  A total of 323 nonheart failure participants underwent clinical evaluation for the presence of kyphosis and spirometry. The severity of kyphosis was estimated from the difference between standing stature and knee-height-derived stature and from the occiput-wall distance.
  
  
  METHODS
  Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and prevalence of obstructive and restrictive ventilatory pattern.
  
  
  RESULTS
  The 130 kyphotic participants (40.2%) had an adjusted 2.5 prevalence odds ratio (POR) for dyspnea (95% confidence interval (CI)=1.1-5.8). FVC% and FEV1% were lower in the presence of kyphosis (P<.01); their deficit was proportional to kyphosis severity. The ventilatory dysfunction was underestimated when reference spirometric parameters were calculated based on standing stature, compared with knee-height derived stature. Of the kyphotic participants, 56.2%, 26.9%, and 16.9% had spirometric normal, obstructive, and restrictive patterns, respectively. Kyphosis was associated with a restrictive (adjusted POR=2.3, 95% CI=1.1-4.8; P=.021) and an obstructive ventilatory pattern (adjusted POR=3.3, 95% CI=1.7-6.5; P<.001).
  
  
  CONCLUSIONS
  In unselected older persons, kyphosis is associated with dyspnea and ventilatory dysfunction of a restrictive and an obstructive type. Kyphosis should be included in the differential diagnosis of dyspnea and ventilatory dysfunction in the elderly.
authors.affiliation: Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatric Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy. dibari@unifi.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Di Bari
authors.forename: Melisenda
authors.initials: M
authors.lastname: Chiarlone
authors.forename: Daniela
authors.initials: D
authors.lastname: Matteuzzi
authors.forename: Simona
authors.initials: S
authors.lastname: Zacchei
authors.forename: Claudia
authors.initials: C
authors.lastname: Pozzi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bellia
authors.forename: Francesca
authors.initials: F
authors.lastname: Tarantini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pini
authors.forename: Giulio
authors.initials: G
authors.lastname: Masotti
authors.forename: Niccoló
authors.initials: N
authors.lastname: Marchionni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007738:Kyphosis / Q000150:complications* / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013147:Spirometry; D014797:Vital Capacity