title: Kyphosis and decline in physical function over 15 years in older community-dwelling women: the Study of Osteoporotic Fractures.
abstract: BACKGROUND
  Maintaining physical function is an important prerequisite for preserving independence in later life. Greater degrees of kyphosis in the thoracic spine are prevalent in older persons and accompanied by reduced physical function in multiple cross-sectional studies. It is unknown whether kyphosis predicts worse physical function over time.
  
  
  METHODS
  We retrospectively assessed whether greater magnitude of kyphosis is associated with decline in self-reported and objectively measured physical function over 15 years. Digitized Cobb angle kyphosis (T4-T12) was derived from supine lateral thoracic spine radiographs in a cohort of 1,196 women aged 65 and older (mean = 69.3 years [SD = 4.0]). Using regression models, we evaluated associations of baseline kyphosis with both self-reported functional status and objectively measured gait speed, grip strength, and timed chair stands cross-sectionally and as change assessed over 15 years.
  
  
  RESULTS
  In cross-sectional multivariate analyses, with each 10-degree increment of kyphosis, grip strength was 0.24 kg lower (p = .02), but there were no significant associations between kyphosis and functional status, gait speed, or timed chair stand, likely reflecting the high functioning study participants. In multivariate longitudinal analysis, with each 10-degree increment in baseline kyphosis, there was 0.07 point additional decline in functional status (p = .09), 0.01 m/s more decline in gait speed (p = .07), and 0.32 s greater decline in time to complete five chair stands (p = .004), but no association with decline in grip strength.
  
  
  CONCLUSIONS
  Greater magnitude of kyphosis may predict worsening lower extremity function over time in older women. Early recognition and preventative measures against kyphosis progression may help preserve physical function over the long term.
authors: Department of Physical Therapy and Rehabilitation Science, University of California, 1500 Owens St., Suite 400, San Francisco, CA 94158, USA. wendy.katzman@ucsfmedctr.org
authors: Wendy B
authors: WB
authors: Katzman
authors: Mei-Hua
authors: MH
authors: Huang
authors: Nancy E
authors: NE
authors: Lane
authors: Kristine E
authors: KE
authors: Ensrud
authors: Deborah M
authors: DM
authors: Kado
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait / Q000502:physiology; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008137:Longitudinal Studies; D058866:Osteoporotic Fractures / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Imaging; Normative aging; Physical function
references: J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31
references: 10811152
references: J Am Geriatr Soc. 1995 Jun;43(6):603-9
references: 7775716
references: Phys Ther. 2002 Apr;82(4):320-8
references: 11922849
references: Phys Ther. 2002 Feb;82(2):128-37
references: 11856064
references: J Bone Miner Res. 1993 Sep;8(9):1137-48
references: 8237484
references: Arch Phys Med Rehabil. 1997 Jan;78(1):26-32
references: 9014953
references: Osteoporos Int. 2011 Jan;22(1):85-90
references: 20480146
references: J Bone Miner Res. 2013 Jan;28(1):179-87
references: 22865329
references: Vital Health Stat 1. 1987 Jun;(21):1-115
references: 3672938
references: J Am Geriatr Soc. 2003 Mar;51(3):314-22
references: 12588574
references: J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
references: 11253156
references: Spine (Phila Pa 1976). 1999 Sep 15;24(18):1921-5
references: 10515017
references: Percept Mot Skills. 2006 Aug;103(1):215-22
references: 17037663
references: N Engl J Med. 1995 Mar 2;332(9):556-61
references: 7838189
references: Arch Intern Med. 1997 Mar 24;157(6):629-34
references: 9080917
references: Am J Phys Med Rehabil. 2004 Mar;83(3):177-86
references: 15043351
references: J Am Geriatr Soc. 2009 Sep;57(9):1569-79
references: 19682114
references: J Am Geriatr Soc. 1997 Dec;45(12):1479-86
references: 9400558
references: Med Sci Sports Exerc. 1997 Jun;29(6 Suppl):S1-205
references: 9243481
references: J Am Geriatr Soc. 2011 Jan;59(1):96-100
references: 21198460
references: Clin Biomech (Bristol, Avon). 2004 Jan;19(1):57-63
references: 14659931
references: J Gerontol A Biol Sci Med Sci. 2007 Jun;62(6):652-7
references: 17595423
references: J Bone Miner Res. 1995 Jun;10(6):890-902
references: 7572313
references: Skeletal Radiol. 1990;19(1):21-6
references: 2326651
references: Am J Epidemiol. 1996 Aug 15;144(4):389-99
references: 8712196
references: J Geriatr Phys Ther. 2008;31(2):49-52
references: 19856549
references: Age Ageing. 1997 Jan;26(1):15-9
references: 9143432
references: Clin Biomech (Bristol, Avon). 1999 Aug;14(7):439-48
references: 10521627
references: J Am Geriatr Soc. 2006 May;54(5):743-9
references: 16696738
references: J Neuroeng Rehabil. 2008 Nov 25;5:32
references: 19032751
references: Age Ageing. 2003 Sep;32(5):497-502
references: 12957998
references: Arch Phys Med Rehabil. 2007 Feb;88(2):192-9
references: 17270517
references: Mayo Clin Proc. 1994 Nov;69(11):1054-9
references: 7967758
references: J Gerontol A Biol Sci Med Sci. 2005 May;60(5):633-7
references: 15972617
references: Spine (Phila Pa 1976). 1998 Sep 15;23(18):1978-85
references: 9779531
references: J Geriatr Phys Ther. 2006;29(2):64-8
references: 16914068
references: J Am Geriatr Soc. 2003 Oct;51(10):1419-26
references: 14511162
references: Osteoporos Int. 2005 Mar;16(3):273-9
references: 15235766
references: Arch Intern Med. 1999 Jun 14;159(11):1215-20
references: 10371229
references: Age Ageing. 1986 Jan;15(1):53-6
references: 3953331
references: Am J Phys Anthropol. 1948 Jun;6(2):234
references: 18867365
references: Osteoporos Int. 2005 Aug;16(8):1004-10
references: 15549266
references: J Bone Miner Res. 2006 Mar;21(3):419-23
references: 16491290
references: Clin Sci (Lond). 1993 Mar;84(3):331-7
references: 8384956
references: J Gerontol A Biol Sci Med Sci. 2005 Jan;60(1):74-9
references: 15741286
references: Am J Epidemiol. 1978 Sep;108(3):161-75
references: 707484