Risk Factor 'Dowager's Hump'

Photo: Elderly woman with spinal curvature

Being bent forward may be an
important clinical finding;
© Marilyn Spievak Brodwick

In a study, researchers found that older white women with both vertebral fractures and the increased spinal curvature that results in the bent-over posture characteristic of hyperkyphosis had an elevated risk for earlier death. The finding was independent of other factors that included age and underlying spinal osteoporosis. Women who had only hyperkyphosis, without vertebral fractures, did not show an increased risk for premature death.

Hyperkyphosis can be caused by a number of factors besides osteoporosis, including habitual poor posture and degenerative diseases of the muscles and intervertebral discs. "Just being bent forward may be an important clinical finding that should serve as a trigger to seek medical evaluation for possible spinal osteoporosis, as vertebral fractures more often than not are a silent disease," said Deborah Kado, the study's primary investigator.

For the study, the researchers reviewed data on 610 women, age 67 to 93, from a cohort of 9,704 participants in the Study of Osteoporotic Fractures. The participants were recruited between 1986 and 1988. Researchers measured spinal curvature with a flexicurve and assessed vertebral fractures from spinal radiographs; they assessed mortality based on follow-ups averaging 13.5 years.

Adjusting for age, as well as osteoporosis-related factors such as low bone density, moderate and severe vertebral fractures, and the number of prevalent vertebral fractures, the researchers found that women with previous vertebral fractures and increasing degrees of spinal curvature were at increased mortality risk from the spinal condition, regardless of age, smoking, spinal bone-mineral density, or the number and severity of their spinal fractures.

"These results add to the growing literature that suggests that hyperkyphosis is a clinically important finding”, the authors write. “Because it is readily observed and is associated with ill health in older persons, hyperkyphosis should be recognised as a geriatric syndrome - a 'multifactorial health condition that occurs when the accumulated effect of impairments in multiple systems renders a person vulnerable to situational challenges.'"

MEDICA.de; Source: University of California, Los Angeles (UCLA), Health Sciences