Relationship Between Age-Related Postural Hyperkyphosis and Sarcopenia.

BACKGROUND

Hyperkyphosis is one of the commonly seen disabilities in the elderly. Loss of muscle mass and function is supposed to be related to age-related hyperkyphosis. We aimed to explain the relationship between sarcopenia and hyperkyphosis in old patients in this study.

METHODS

142 patients who were in the polyclinic of geriatrics of Gaziantep University Hospital were enrolled in this cross-sectional study. Hyperkyphotic patients were included in the study group, and non-hyperkyphotic patients were included in the control group by experienced staff. Their mean age was 72±6.9. Thirty-six of them were male, and 106 of them were female. The EWGSOP 2 criteria were used for the diagnosis of sarcopenia. SARC-F (sluggishness, assistance in walking, rising from a chair, climb stairs, falls) test was performed on all patients. The handgrip test was applied to patients who had a score ≥4 from SARC-F. We conducted bioimpedance analysis of the probable sarcopenic patients who were diagnosed with handgrip assessment. Four-meter gait speed test, Timed Up and Go Test (TUG) and Tinetti Test were applied to all patients to evaluate gait speed. Hyperkyphosis was evaluated with the bloc method in the Rancho Bernardo Study. Numbers of the blocks used for keeping patients in a neutral position were recorded. We defined hyperkyphosis as the state in that one or more blocks are needed to maintain the patient's neutral position on the radiology table.

RESULTS

Hyperkyphosis was positively related to lower extremity dysfunction which was assessed by 4-m-gait speed test (p=0.018) and TUG (p=0.042). A significant relationship between gait speed and hyperkyphosis was revealed when evaluated with one-way MANOVA (F [5,92] =2.588, p=0.031, Wilk's Λ=0.877, partial η2=0.123). We found a significant relationship between TUG and the number of blocks needed to restore neutral position by linear regression analyses (r2 =0.059, p=0.044). We found a cut-off value of gait speed as 0.65 m/s for the presence of hyperkyphosis (sensitivity:60%, specificity:70%, CI=95%, p<0.001, AUC=0.710). Tinetti balance, gait and total test scores were also negatively related to hyperkyphosis (p=0.006; 0,027; 0.031).

CONCLUSION

In previous studies, vertebral compression fractures, degenerative disc disease, weakness of back extensor muscles and genetic predisposition were suggested as predisposing factors for age-related kyperkyphosis. Different from these in our study, lower extremity muscle function was found to be related to age-related hyperkyphosis. More studies on this subject could be helpful. Hyperkifosis prognosis in severe sarcopenic groups might be a new research topic.