Journal
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
Volume 67, Issue 2, Pages 191-195Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/gerona/glr160
Keywords
Kyphosis; Hyperkyphosis; Prevalence; Spinal muscle; Fat infiltration
Categories
Funding
- UCSF
- National Institute of Child Health and Human Development
- Office of Research on Women's Health [5 K12 HD052163]
- National Institutes of Health (NIH) [2R56AG024246]
- National Institute on Aging (NIA) [N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106, R01-AG028050]
- NINR [R01-NR012459]
- NIH, NIA
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Background. Older adults with hyperkyphosis are at increased risk of falls, fractures, and functional decline. Modifiable risk factors for hyperkyphosis have not been well studied. Our objective was to determine whether spinal muscle area and density are associated with hyperkyphosis, independent of age, race, sex, bone mineral density, and trunk fat. Methods. Using data from the Pittsburgh site of the Health, Aging, and Body Composition study, we performed a baseline cross-sectional analysis. Participants were black and white men and women 70-79 years old (N = 1172), independent in activities of daily living and able to walk 1/4 mile and up 10 steps without resting. We measured Cobb's angle of kyphosis from supine lateral scout computed tomography scans, and categorized hyperkyphosis as Cobb's angle >40 degrees. Axial images from lateral scout computed tomography scans assessed spinal extensor muscle cross-sectional area and density (proxy for fat infiltration). Results. In our sample, 21% had hyperkyphosis. Prevalence in black men was 11%; in white men, 17%; in black women, 26%; and in white women, 30%. In multivariate analysis, each standard deviation increase in muscle density was associated with a 29% reduction in the odds of hyperkyphosis, independent of covariates. Muscle area was not significantly associated with hyperkyphosis. Conclusions. Lower spinal muscle density is associated with hyperkyphosis in healthy community-dwelling older adults. This potentially modifiable risk factor could be targeted in exercise interventions. Randomized trials are needed to determine whether an exercise program targeting spinal muscle density reduces hyperkyphosis and in turn improves health outcomes.
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