The Prevalence and Negative Effects of Thoracic Hyperkyphosis on Chinese Community-Dwelling Older Adults in Wuhan, Hubei Province, China

Abstract

Background: Globally, 20% to 50% older adults have been found to have thoracic hyperkyphosis. Negative effects on physical performance have been reported. However, there has been a lack of research on the prevalence and negative effects of thoracic hyperkyphosis among Chinese community-dwelling elderly.

Design: A cross-sectional study.

Setting: The communities in Wuhan, China.

Participants: Three hundred and ninety-five Chinese community-dwelling older adults with thoracic hyperkyphosis.

Measures: Chinese community-dwelling older adults aged 60 or above lived in Wuhan, China from August to December 2018 were recruited for spine and physical performance assessments. The primary outcome was the prevalence of thoracic hyperkyphosis estimated according to the angle of kyphosis which was measured by manual inclinometers. The secondary outcomes were the effects of thoracic hyperkyphosis on physical performance measured by One-leg Standing Test (OLS), Timed Up & Go Test (TUG), Chest Expansion Test (CE), Six Minutes Walking Test (6MWT), and Farsi Version of Functional Gait Assessment (FGA). The socio-demographic and health-related information were collected by a questionnaire.

Results: Among 395 participants, the mean angle of kyphosis was 49.0° ± 10.5°, 75.2% of participants had the angle of kyphosis >40° (i.e., having thoracic kyperkyphosis). Compared with older adults having no thoracic hyperkyphosis, older adults with thoracic hyperkyphosis had increased risks performing impaired in OLS (OR=4.55, 95% CI 2.18–9.53, p<0.001), TUG (OR=6.08, 95% CI 2.57–14.40, p<0.001), CE (OR=3.23, 95% CI 1.63–6.38, p=0.001), 6MWT (OR=4.64, 95% CI 1.98–10.86, p<0.001), and FGA (OR=5.18, 95% CI 2.25–11.89, p<0.001) after controlling socio-demographic and health-related factors.

Conclusion: The thoracic hyperkyphosis had high prevalence and associated with impaired performance in balance, gait, and cardiopulmonary function tests among Chinese community-dwelling older adults, which calls for the future intervention.