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老年男性脊柱后凸患者的身体功能

Physical function in older men with hyperkyphosis.

作者信息

Katzman Wendy B, Harrison Stephanie L, Fink Howard A, Marshall Lynn M, Orwoll Eric, Barrett-Connor Elizabeth, Cawthon Peggy M, Kado Deborah M

机构信息

Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco.

California Pacific Medical Center Research Institute, San Francisco.

出版信息

J Gerontol A Biol Sci Med Sci. 2015 May;70(5):635-40. doi: 10.1093/gerona/glu213. Epub 2014 Nov 27.

Abstract

BACKGROUND

Age-related hyperkyphosis has been associated with poor physical function and is a well-established predictor of adverse health outcomes in older women, but its impact on health in older men is less well understood.

METHODS

We conducted a cross-sectional study to evaluate the association of hyperkyphosis and physical function in 2,363 men, aged 71-98 (M = 79) from the Osteoporotic Fractures in Men Study. Kyphosis was measured using the Rancho Bernardo Study block method. Measurements of grip strength and lower extremity function, including gait speed over 6 m, narrow walk (measure of dynamic balance), repeated chair stands ability and time, and lower extremity power (Nottingham Power Rig) were included separately as primary outcomes. We investigated associations of kyphosis and each outcome in age-adjusted and multivariable linear or logistic regression models, controlling for age, clinic, education, race, bone mineral density, height, weight, diabetes, and physical activity.

RESULTS

In multivariate linear regression, we observed a dose-related response of worse scores on each lower extremity physical function test as number of blocks increased, p for trend ≤.001. Using a cutoff of ≥4 blocks, 20% (N = 469) of men were characterized with hyperkyphosis. In multivariate logistic regression, men with hyperkyphosis had increased odds (range 1.5-1.8) of being in the worst quartile of performing lower extremity physical function tasks (p < .001 for each outcome). Kyphosis was not associated with grip strength in any multivariate analysis.

CONCLUSIONS

Hyperkyphosis is associated with impaired lower extremity physical function in older men. Further studies are needed to determine the direction of causality.

摘要

背景

与年龄相关的脊柱后凸与身体功能不佳有关,并且是老年女性不良健康结局的公认预测指标,但人们对其对老年男性健康的影响了解较少。

方法

我们进行了一项横断面研究,以评估来自男性骨质疏松性骨折研究的2363名年龄在71 - 98岁(平均年龄79岁)男性的脊柱后凸与身体功能之间的关联。使用兰乔贝纳多研究模块法测量脊柱后凸。分别将握力和下肢功能测量结果作为主要结局,包括6米以上的步态速度、窄道行走(动态平衡测量)、重复起坐能力和时间,以及下肢力量(诺丁汉功率计)。我们在年龄调整和多变量线性或逻辑回归模型中研究了脊柱后凸与每个结局之间的关联,同时控制年龄、诊所、教育程度、种族、骨密度、身高、体重、糖尿病和身体活动。

结果

在多变量线性回归中,我们观察到随着模块数量增加,每项下肢身体功能测试得分变差呈剂量相关反应,趋势p值≤0.001。以≥4个模块为临界值,20%(n = 469)的男性被判定为脊柱后凸。在多变量逻辑回归中,脊柱后凸的男性在执行下肢身体功能任务方面处于最差四分位数的几率增加(范围为1.5 - 1.8)(每个结局的p值均<0.001)。在任何多变量分析中,脊柱后凸与握力均无关联。

结论

脊柱后凸与老年男性下肢身体功能受损有关。需要进一步研究以确定因果关系的方向。

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