title: Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population.
abstract: METHODS
  A prospective self-assessment analysis and evaluation of nutritional and radiographic parameters in a consecutive series of healthy adult volunteers older than 60 years.
  
  
  OBJECTIVE
  To ascertain the prevalence of adult scoliosis, assess radiographic parameters, and determine if there is a correlation with functional self-assessment in an aged volunteer population.
  
  
  BACKGROUND
  There exists little data studying the prevalence of scoliosis in a volunteer aged population, and correlation between deformity and self-assessment parameters.
  
  
  METHODS
  There were 75 subjects in the study. Inclusion criteria were: age > or =60 years, no known history of scoliosis, and no prior spine surgery. Each subject answered a RAND 36-Item Health Survey questionnaire, a full-length anteroposterior standing radiographic assessment of the spine was obtained, and nutritional parameters were analyzed from blood samples. For each subject, radiographic, laboratory, and clinical data were evaluated. The study population was divided into 3 groups based on frontal plane Cobb angulation of the spine. Comparison of the RAND 36-Item Health Surveys data among groups of the volunteer population and with United States population benchmark data (age 65-74 years) was undertaken using an unpaired t test. Any correlation between radiographic, laboratory, and self-assessment data were also investigated.
  
  
  RESULTS
  The mean age of the patients in this study was 70.5 years (range 60-90). Mean Cobb angle was 17 degrees in the frontal plane. In the study group, 68% of subjects met the definition of scoliosis (Cobb angle >10 degrees). No significant correlation was noted among radiographic parameters and visual analog scale scores, albumin, lymphocytes, or transferrin levels in the study group as a whole. Prevalence of scoliosis was not significantly different between males and females (P > 0.03). The scoliosis prevalence rate of 68% found in this study reveals a rate significantly higher than reported in other studies. These findings most likely reflect the targeted selection of an elderly group. Although many patients with adult scoliosis have pain and dysfunction, there appears to be a large group (such as the volunteers in this study) that has no marked physical or social impairment.
  
  
  CONCLUSIONS
  Previous reports note a prevalence of adult scoliosis up to 32%. In this study, results indicate a scoliosis rate of 68% in a healthy adult population, with an average age of 70.5 years. This study found no significant correlations between adult scoliosis and visual analog scale scores or nutritional status in healthy, elderly volunteers.
authors.affiliation: Department of Orthopaedic Surgery, Spine Service, Maimonides Medical Center, Brooklyn, NY, USA. fschwab@worldnet.att.net
authors.forename: Frank
authors.initials: F
authors.lastname: Schwab
authors.forename: Ashok
authors.initials: A
authors.lastname: Dubey
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Gamez
authors.forename: Abdelkrim Benchikh
authors.initials: AB
authors.lastname: El Fegoun
authors.forename: Ki
authors.initials: K
authors.lastname: Hwang
authors.forename: Murali
authors.initials: M
authors.lastname: Pagala
authors.forename: J-P
authors.initials: JP
authors.lastname: Farcy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009752:Nutritional Status; D011446:Prospective Studies; D012600:Scoliosis / Q000175:diagnosis* / Q000453:epidemiology*; D012649:Self Concept; D012720:Severity of Illness Index