Background We investigated prospectively among community-dwelling older adults aged 65 years and over whether a larger kyphosis angle is associated with poorer physical performance (balance, muscle strength or both), and whether this association is unidirectional. Methods ale 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=1220, 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%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. Conclusions 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.

中文翻译：

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社区老年人脊柱后凸角与身体机能的关系

背景 我们前瞻性地调查了居住在社区的 65 岁老年人，以及更大的脊柱后凸角度是否与较差的身体表现（平衡、肌肉力量或两者）相关，以及这种关联是否是单向的。方法 啤酒和女性参与者在基线和 2 年后进行了一项多组分身体性能测试，其中包含步态、肌肉力量和平衡的子分数。还在基线和随访时测量了手的握力。Cobb 角是在基于 DXA 的椎骨骨折评估中测量的，该评估是在基线和随访时进行的。通过线性和逻辑回归分析，我们研究了脊柱后凸角度与身体表现之间的关联，反之亦然。我们对性别进行了分层，并测试了按年龄和研究中心进行的效果修正。结果 平均后凸角为 37°，15% 的参与者（n=1220，平均年龄 72.9±5.7 岁）有过度后凸（Cobb 角≥50°）。在横断面和纵向分析中，年龄最大四分位数（≥77 岁）的女性在基线时较大的后凸角度与较差的总体身体表现评分独立相关（基线 B-0.32，95%CI -0.56--0.08 ; 随访 B 0.32, 95%CI -0.55--0.10)。基线时的身体表现与脊柱后凸进展之间没有关联。结论 较大的脊柱后凸角度与基线时和随时间推移的较差身体表现独立相关，并且这种关联的方向是单向的。这些结果强调了早期发现和治疗过度后凸的重要性，以防止后凸角度进一步恶化，