Hyperkyhosis is thought to be a fall risk factor in older adults. This large study of older men found that fall risk increased with greater kyphosis measured with the blocks method, but did not find an association between kyphosis and falls when measured by the commonly used the Cobb angle method. INTRODUCTION Research suggests an association between hyperkyphosis and falls in community-dwelling older adults, though this has not been investigated within large, population-based studies. This study sought to determine whether two measures of kyphosis prospectively predict fall risk over 3 years among older men. METHODS Within the Osteoporotic Fractures in Men Study (MrOS), we conducted two 3-year prospective studies of 2346 and 2928 men. The first group had kyphosis measured by the Cobb angle at visit 1, while the second group had kyphosis assessed with the blocks method at visit 3; both groups then self-reported falls tri-annually for 3 years. Poisson regression with GEE was used to obtain relative risks (RR) of falls. RESULTS The fall rates over 3 years were 651/1000 person-years among the visit 1 sample (mean age 74 ± 6 years) and 839/1000 person-years among the visit 3 sample (mean age 79 ± 5 years). In adjusted models of the visit 3 sample, the risk of falls was increased by 12% for each standard deviation increase (1.4 blocks) in the number of blocks required to achieve a neutral head and neck position (RR = 1.12, 95% CI = 1.06, 1.18). The Cobb angle was not associated with falls in the visit 1 sample. CONCLUSIONS Although the Cobb angle did not predict falls in community-dwelling older men over 3 years, the blocks method of measuring kyphosis was predictive of falls in this population. This difference could be due to the Cobb angle's focus on thoracic kyphosis, whereas the blocks method may additionally capture abnormal cervical spine curvature.

中文翻译：

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社区老年男性的脊柱后凸和 3 年跌倒风险。

脊柱侧弯被认为是老年人跌倒的危险因素。这项针对老年男性的大型研究发现，使用积木法测量的脊柱后凸越大，跌倒风险越高，但使用常用的 Cobb 角法测量时，并未发现脊柱后凸与跌倒之间存在关联。引言 研究表明，在社区居住的老年人中，脊柱后凸与跌倒之间存在关联，尽管尚未在基于人群的大型研究中对此进行调查。本研究旨在确定两种后凸畸形测量是否可以前瞻性地预测老年男性 3 年以上的跌倒风险。方法 在男性骨质疏松性骨折研究 (MrOS) 中，我们对 2346 名和 2928 名男性进行了两项为期 3 年的前瞻性研究。第一组在就诊 1 时用 Cobb 角测量后凸，而第二组在第 3 次就诊时用块法评估了脊柱后凸；然后，两组都自我报告每三年跌一次，持续 3 年。使用 GEE 的泊松回归来获得跌倒的相对风险 (RR)。结果 就诊 1 样本（平均年龄 74 ± 6 岁）和就诊 3 样本（平均年龄 79 ± 5 岁）的 3 年内跌倒率为 651/1000 人年。在访问 3 样本的调整模型中，实现头颈部中性位置所需的块数每增加一个标准差（1.4 个块），跌倒的风险就会增加 12%（RR = 1.12，95% CI = 1.06、1.18）。Cobb 角与访问 1 样本中的跌倒无关。结论 虽然 Cobb 角度不能预测社区居住的老年男性 3 年以上的跌倒，测量脊柱后凸的块法可预测该人群的跌倒。这种差异可能是由于 Cobb 角专注于胸椎后凸，而块法可能额外捕获异常的颈椎弯曲。