Volume 52, Issue 10 p. 1662-1667

Hyperkyphotic Posture Predicts Mortality in Older Community-Dwelling Men and Women: A Prospective Study

Deborah M. Kado MD, MS

Deborah M. Kado MD, MS

From the * Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California.

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Mei-Hua Huang DrPH

Mei-Hua Huang DrPH

From the * Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California.

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Arun S. Karlamangla MD, PhD

Arun S. Karlamangla MD, PhD

From the * Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California.

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Elizabeth Barrett-Connor MD

Elizabeth Barrett-Connor MD

From the * Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California.

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Gail A. Greendale MD

Gail A. Greendale MD

From the * Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California.

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First published: 23 September 2004
Citations: 152
Address correspondence to Deborah M. Kado, MD, MS, Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095. E-mail: [email protected]

Supported by Public Health Service Grants AG007181-15 and 1K12AG01004 and the Claude D. Pepper Older Americans Independent Center (5P60AG10415-11). This abstract was presented at the annual meeting of the American Society of Bone and Mineral Research, in San Antonio, Texas, September 22, 2002.

Abstract

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.