The prevalence and negative effects of thoracic kyphosis in the general Chinese community-dwelling older population: A cross-sectional study

Abstract

Background and Objectives: Thoracic kyphosis refers to an excessive outward curvature of the thoracic spine. The increased angle of thoracic kyphosis has been reported to be associated with diminished physical function, impairment of cardiopulmonary function, decreased balance and decreased gait performance. Worldwide, the prevalence of thoracic kyphosis ranges from 20% to 40% among community-dwelling population aged ≥ 60-year-old. In China, 57% of older female patients with primary osteoporosis also report thoracic kyphosis. In the past twenty years in China, the prevalence and the negative effects of thoracic kyphosis were only studied among osteoporosis in-patients. The current study aims to estimate the prevalence of thoracic kyphosis and investigate negative effects of thoracic kyphosis in the community-dwelling older Chinese people. Methods: A cross-sectional survey was conducted in Wuhan, China. Chinese elderly aged ≥60 without cognitive impairment were recruited from the community. Each participant completed a questionnaire including sociodemographic information, illnesses, exercise habit; an inclinometer kyphosis angle assessment; a set of physical assessments including one gait assessment, one balance assessment (namely One Leg Standing Test), and two cardiopulmonary function assessments (namely Six Minutes Walking Test, and Chest Expansion). The prevalence of thoracic kyphosis was calculated according to kyphosis angle >40°. Logistic regression was conducted to examine the effects of thoracic kyphosis on gait performance, balance, and cardiopulmonary functions. Results: Among the 350 participants, 77.1% had the inclinometer angle >40°. The logistic regression found after controlling the socio-demographics, exercise intensity, and illnesses, compared with no kyphosis participants, participants with kyphosis had higher risk of impaired performance in gait assessment (OR=4.1, 95% CI 1.7-9.6), One Leg Standing Test (OR=4.1, 95% CI 2.1-8.0), Six Minutes Walking Test (OR=3.4, 95% CI 1.4-8.3), and Chest Expansion (OR=2.5, 95% CI 1.2-5.3). Conclusions: Majority of the community-dwelling older Chinese people in this survey had thoracic kyphosis with negative effects on gait performance, balance and cardiopulmonary function.