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Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study
Deborah M Kado1, Mei-Hua Huang, Arun S Karlamangla
1Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California 90095, USA. dkado@mednet.ucla.edu
Objectives:
To determine the association between hyperkyphotic posture and rate of mortality and cause-specific mortality in older persons.
Design:
Prospective cohort study.
Setting:
Rancho Bernardo, California.
Participants:
Subjects were 1,353 participants from the Rancho Bernardo Study who had measurements of kyphotic posture made at an osteoporosis visit between 1988 and 1991.
Measures:
Kyphotic posture was measured as the number of 1.7-cm blocks that needed to be placed under the participant's head to achieve a neutral head position when lying supine on a radiology table. Demographic and clinical characteristics and health behaviors were assessed at a clinic visit using standard questionnaires. Participants were followed for an average of 4.2 years, with mortality and cause of death confirmed using review of death certificates.
Results:
Hyperkyphotic posture, defined as requiring one or more blocks under the occiput to achieve a neutral head position while lying supine, was more common in men than women (44% in men, 22% of women, P<.0001). In age- and sex-adjusted analyses, persons with hyperkyphotic posture had a 1.44 greater rate of mortality (95% confidence interval (CI)=1.12-1.86, P=.005). In multiply adjusted models, the increased rate of death associated with hyperkyphotic posture remained significant (relative hazard=1.40, 95% CI=1.08-1.81, P=.012). In cause-specific mortality analyses, hyperkyphotic posture was specifically associated with an increased rate of death due to atherosclerosis.
Conclusion:
Older men and women with hyperkyphotic posture have higher mortality rates.
