Thoracic Kyphosis and Ventilatory Dysfunction in Unselected Older Persons: An Epidemiological Study in Dicomano, Italy

J Am Geriatr Soc. 2004 Jun;52(6):909-15. doi: 10.1111/j.1532-5415.2004.52257.x.

Abstract

Objectives: To assess whether kyphosis is associated with ventilatory dysfunction in older community dwellers.

Design: Cross-sectional study.

Setting: The unselected population of Dicomano, Italy aged>or=65 years.

Participants: A total of 323 nonheart failure participants underwent clinical evaluation for the presence of kyphosis and spirometry. The severity of kyphosis was estimated from the difference between standing stature and knee-height-derived stature and from the occiput-wall distance.

Measurements: Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and prevalence of obstructive and restrictive ventilatory pattern.

Results: The 130 kyphotic participants (40.2%) had an adjusted 2.5 prevalence odds ratio (POR) for dyspnea (95% confidence interval (CI)=1.1-5.8). FVC% and FEV1% were lower in the presence of kyphosis (P<.01); their deficit was proportional to kyphosis severity. The ventilatory dysfunction was underestimated when reference spirometric parameters were calculated based on standing stature, compared with knee-height derived stature. Of the kyphotic participants, 56.2%, 26.9%, and 16.9% had spirometric normal, obstructive, and restrictive patterns, respectively. Kyphosis was associated with a restrictive (adjusted POR=2.3, 95% CI=1.1-4.8; P=.021) and an obstructive ventilatory pattern (adjusted POR=3.3, 95% CI=1.7-6.5; P<.001).

Conclusion: In unselected older persons, kyphosis is associated with dyspnea and ventilatory dysfunction of a restrictive and an obstructive type. Kyphosis should be included in the differential diagnosis of dyspnea and ventilatory dysfunction in the elderly.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anthropometry
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume
  • Humans
  • Italy / epidemiology
  • Kyphosis / complications*
  • Kyphosis / epidemiology
  • Male
  • Prevalence
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / etiology*
  • Spirometry
  • Vital Capacity