title: Increasing kyphosis predicts worsening mobility in older community-dwelling women: a prospective cohort study.
abstract: OBJECTIVE
  To determine whether increasing kyphosis angle was independently associated with poorer mobility as measured according to the Timed Up and Go Test (TUG), after controlling for other established risk factors.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Eleven clinical centers in the United States.
  
  
  METHODS
  Two thousand seven hundred seventy-seven women aged 55 to 80 randomized to the placebo arms of the Fracture Intervention Trial, a randomized controlled trial of the effect of alendronate on risk for osteoporotic fractures.
  
  
  METHODS
  The primary predictor was change in kyphosis angle, measured using the Debrunner Kyphometer; the outcome was change in mobility, measured as performance time on the TUG. Covariates were baseline age, kyphosis angle, body mass index (BMI), self-reported health status, grip strength, change in total hip bond mineral density (BMD), and number of vertebral fractures over a mean of 4.4 years.
  
  
  RESULTS
  Greater kyphosis angle predicted longer mobility performance times (P<.001), independent of other significant predictors of worsening mobility including age, baseline kyphosis, health status, grip strength, BMI, change in hip BMD, and new vertebral fractures. TUG performance times increased by 0.02 seconds (95% confidence interval (CI)=0.01-0.03) for every 5° increase in kyphosis angle, more than the increase in mobility time of 0.01 seconds (95% CI=0.005-0.03) over 1 year observed in this cohort.
  
  
  CONCLUSIONS
  Increasing kyphosis angle is independently associated with worsening mobility. Interventions are needed to prevent or reduce increasing kyphosis and mobility decline.
authors.affiliation: Department of Physical Therapy and Rehabilitation Science, University of California at Los Angeles, Los Angeles, California, USA. wendy.katzman@ucsfmedctr.org
authors.forename: Wendy B
authors.initials: WB
authors.lastname: Katzman
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Kris
authors.initials: K
authors.lastname: Ensrud
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Black
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Kado
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005598:Fractures, Spontaneous / Q000503:physiopathology; D018737:Hand Strength; D006801:Humans; D007738:Kyphosis / Q000503:physiopathology; D008875:Middle Aged; D051346:Mobility Limitation; D010024:Osteoporosis / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States