The relationship between frailty and spinal alignment in the elderly general population: a two-year longitudinal...

Area of Science:

• Gerontology
• Orthopedics
• Public Health

Background:

• Frailty, characterized by age-related physical decline, may impact spinal alignment.
• The Cardiovascular Health Study (CHS) criteria are suitable for assessing physical function in frailty.
• Previous research has not explored the link between frailty (using CHS criteria) and spinal alignment.

Purpose of the Study:

• To investigate the association between frailty, assessed by the Japanese version of the CHS (J-CHS) criteria, and spinal radiographic parameters.
• To examine changes in spinal alignment over a two-year period in relation to frailty status.

Main Methods:

• 211 volunteers (aged 60-89) from the TOEI study were categorized into robust, pre-frail, and frail groups based on J-CHS criteria in 2018.
• Whole-spine standing X-rays were used to evaluate radiographic parameters.
• Follow-up assessments were conducted in 2020 to track changes.

Main Results:

• Low physical activity was the most prevalent characteristic in pre-frail (64%) and frail (100%) groups.
• Significant differences in C7 sagittal vertical axis (SVA) were observed in 2020 (p=0.047).
• Significant differences in C2 SVA were found in 2018 (p=0.019) and 2020 (p=0.041) across the groups.

Conclusions:

• Frailty is associated with a progression of poor global spinal alignment over two years.
• Frailty may initiate with reduced activity and increased exhaustion.
• Interventions promoting exercise and activity are vital for mitigating frailty progression and maintaining spinal health.