Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study

J Am Geriatr Soc. 2004 Oct;52(10):1662-7. doi: 10.1111/j.1532-5415.2004.52458.x.


Objectives: To determine the association between hyperkyphotic posture and rate of mortality and cause-specific mortality in older persons.

Design: Prospective cohort study.

Setting: Rancho Bernardo, California.

Participants: Subjects were 1,353 participants from the Rancho Bernardo Study who had measurements of kyphotic posture made at an osteoporosis visit between 1988 and 1991.

Measures: Kyphotic posture was measured as the number of 1.7-cm blocks that needed to be placed under the participant's head to achieve a neutral head position when lying supine on a radiology table. Demographic and clinical characteristics and health behaviors were assessed at a clinic visit using standard questionnaires. Participants were followed for an average of 4.2 years, with mortality and cause of death confirmed using review of death certificates.

Results: Hyperkyphotic posture, defined as requiring one or more blocks under the occiput to achieve a neutral head position while lying supine, was more common in men than women (44% in men, 22% of women, P<.0001). In age- and sex-adjusted analyses, persons with hyperkyphotic posture had a 1.44 greater rate of mortality (95% confidence interval (CI)=1.12-1.86, P=.005). In multiply adjusted models, the increased rate of death associated with hyperkyphotic posture remained significant (relative hazard=1.40, 95% CI=1.08-1.81, P=.012). In cause-specific mortality analyses, hyperkyphotic posture was specifically associated with an increased rate of death due to atherosclerosis.

Conclusion: Older men and women with hyperkyphotic posture have higher mortality rates.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arteriosclerosis / etiology*
  • Arteriosclerosis / mortality
  • California
  • Comorbidity
  • Confounding Factors, Epidemiologic
  • Death Certificates
  • Female
  • Humans
  • Kyphosis / classification
  • Kyphosis / complications*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Severity of Illness Index
  • Sex Distribution
  • Supine Position