The Association Between the Kyphosis Angle and Physical Performance in Community-Dwelling Older Adults

Marije C. Koelé, Hanna C. Willems, Iris M. Harmsen, Karin M.A. Swart, Suzanne C. van Dijk, Paul Lips, Lisette C.P.G.M. de Groot, Tischa J.M. van der Cammen, M. Carola Zillikens, Natasja M. van Schoor, Nathalie van der Velde*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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BACKGROUND: We investigated prospectively among community-dwelling older adults aged 65 years and older whether a larger kyphosis angle is associated with poorer physical performance (balance, muscle strength, or both), and whether this association is unidirectional. METHODS: Male and female participants performed a multicomponent physical performance test with subscores for gait, muscle strength, and balance at baseline and after 2 years. Hand grip strength was also measured at baseline and at follow-up. The Cobb angle was measured on DXA-based Vertebral Fracture Assessments, made at the baseline and follow-up visit. Through linear and logistic regression analysis, we investigated the association between the kyphosis angle and physical performance and vice versa. We stratified for sex, and tested for effect modification by age and study center. RESULTS: The mean kyphosis angle was 37° and 15% of the participants (n = 1 220, mean age 72.9 ± 5.7 years) had hyperkyphosis (Cobb angle ≥50°). A larger kyphosis angle at baseline was independently associated with a poorer total physical performance score in women of the oldest quartile (≥77 years) in both the cross-sectional and longitudinal analyses (baseline B -0.32, 95% confidence interval [CI] -0.56-0.08; follow-up B 0.32, 95% CI -0.55-0.10). There was no association between physical performance at baseline and kyphosis progression. CONCLUSION: A larger kyphosis angle is independently associated with a poorer physical performance at baseline and over time, and the direction of this association is unidirectional. These results emphasize the importance of early detection and treatment of hyperkyphosis to prevent further worsening of the kyphosis angle, thereby potentially preserving physical performance.

Original languageEnglish
Pages (from-to)2298-2305
Number of pages8
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Issue number11
Publication statusPublished - Nov 2022

Bibliographical note

This cohort study received no specific grant from any funding agency in the
public, commercial, or not-for-profit sectors. The original B-PROOF trial was
supported and funded by The Netherlands Organization for Health Research
Journals of Gerontology: MEDICAL SCIENCES, 2022, Vol. 77, No. 11 2303
Downloaded from by Erasmus University Library user on 30 November 2022
and Development (ZonMw, Grant 6130.0031), The Hague; unrestricted grant
from Nederlandse Zuivel Organisatie (Dutch Dairy Association), Zoetermeer;
Orthica, Almere; Netherlands Consortium for Healthy Ageing, Leiden/
Rotterdam; Ministry of Economic Affairs, Agriculture and Innovation (project KB-15-004-003), The Hague; Wageningen University, Wageningen; VUmc,
Amsterdam; Erasmus Medical Center, Rotterdam.

Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America.


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