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Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Impaired Physical Function: The Rancho Bernardo Study
Wendy B Katzman1, Mei-Hua Huang2, Donna Kritz-Silverstein3
1University of California, San Francisco, California.
Journal of the American Geriatrics Society
|April 4, 2017
Summary
Diffuse idiopathic skeletal hyperostosis (DISH) is associated with physical functional impairment in older adults, particularly difficulty bending and performing chair stands in men. These findings highlight the clinical relevance of DISH beyond radiographic changes.
Area of Science:
- Rheumatology and Geriatric Medicine
- Skeletal Health and Aging
- Physical Function and Mobility
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) is a common skeletal condition in older adults, characterized by calcification and ossification of ligaments and entheses.
- The clinical significance of DISH, particularly its impact on physical function, remains incompletely understood, with some viewing it as an incidental radiographic finding.
Purpose of the Study:
- To investigate the associations between diffuse idiopathic skeletal hyperostosis (DISH) and both self-reported and objectively measured physical function in a cohort of older adults.
- To determine if DISH is independently associated with limitations in mobility and strength, beyond other potential confounding factors.
Main Methods:
- Cross-sectional analysis of data from the Rancho Bernardo Study, including 630 men and 961 women (mean age 71.5 years).
- DISH was diagnosed using lateral thoracic and lumbar spine radiographs.
- Physical function was assessed via self-reported difficulties (bending, walking, climbing stairs) and performance-based measures (grip strength, chair-stand test).
Main Results:
- DISH prevalence was 25.6% in men and 5.5% in women.
- Individuals with DISH showed significantly increased odds of self-reported difficulty bending (OR = 1.69) and worse grip strength (-1.08 kg).
- Among men, DISH was associated with a higher likelihood of inability to complete five chair stands without arm support (OR = 2.17).
Conclusions:
- Diffuse idiopathic skeletal hyperostosis (DISH) is associated with significant physical functional impairments in older adults, including reduced bending ability and strength.
- The findings suggest that DISH is not merely a radiographic finding but has tangible clinical correlations with functional limitations, particularly in older men.
- Further research into the management of DISH may help mitigate functional decline and improve quality of life in affected individuals.