Abstract
BackgroundVertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/or flexed posture with future fall incidents in older adults within the next year.MethodsPatients were recruited at a geriatric outpatient clinic. Vertebral fractures were evaluated on lateral radiographs of the spine with the semi-quantitative method of Genant; the degree of thoracic kyphosis was assessed with the Cobb angle. The occiput-to-wall distance was used to determine a flexed posture. Self-reported falls were prospectively registered by monthly phone contact for the duration of 12 months.ResultsFifty-one older adults were included; mean age was 79 years (SD = 4.8). An increased thoracic kyphosis was independently associated with future falls (OR 2.13; 95% CI 1.10-4.51). Prevalent vertebral fractures had a trend towards significancy (OR 3.67; 95% CI 0.85-15.9). A flexed posture was not significantly associated with future falls.ConclusionOlder adults with an increased thoracic kyphosis are more likely to fall within the next year. We suggest clinical attention for underlying causes. Because patients with increased thoracic curvature of the spine might have underlying osteoporotic vertebral fractures, clinicians should be aware of the risk of a new fracture.
Highlights
IntroductionAn increased thoracic kyphosis and a flexed posture are associated with falls
Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls
Since very few fall incidents were reported in the six-month follow-up period, we extended the falls-and fracture calendar with another six months
Summary
An increased thoracic kyphosis and a flexed posture are associated with falls. This was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/or flexed posture with future fall incidents in older adults within the year. Falls in the older population are generally caused by a combination of risk factors, such as balance and gait disorders, poor vision, polypharmacy and environmental factors, and could lead to serious injuries such as fractures [2]. Thoracic vertebral fractures could increase the kyphotic curvature of the thoracic spine [11], and may cause a flexed posture [12]. A flexed posture is the more extreme expression of an increased thoracic kyphosis, when the compensatory mechanisms to correct the kyphosis fail [12]
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