Spinal posture in the sagittal plane is associated with future dependence in activities of daily living: A community-based cohort study of older adults in Japan

Kojiro Kamitani, Takehiro Michikawa, Satoko Iwasawa, Norihito Eto, Taichiro Tanaka, Toru Takebayashi, Yuji Nishiwaki

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Abstract

Background. Accumulated evidence shows how important spinal posture is for aged populations in maintaining independence in everyday life. However, the cross-sectional designs of most previous studies prevent elucidation of the relationship between spinal posture and future dependence in activities of daily living (ADL). We tried to clarify the association by measuring spinal posture noninvasively in a community-based prospective cohort study of older adults, paying particular attention to thoracic curvature, lumbar curvature, sacral hip angle, and inclination to determine which parameter is most strongly associated with dependence in ADL.Methods. Spinal posture was evaluated in 804 participants (338 men, 466 women, age range: 65-94 years) who were independent in ADL at baseline. We defined dependence in ADL as admission to a nursing home or need of home assistance. During the 4.5-year follow-up period, 126 (15.7%) participants became dependent in ADL. The relationship between the spinal posture parameters and outcome was assessed by dividing the participants into sex-specific quartiles of the parameters.Results. Only inclination (angle subtended between the vertical and a line joining C7 to the sacrum) was associated with outcome, although lumbar curvature also showed a marginal association. The age- and sex-adjusted odds ratio for a 1 unit increase in the quartiles of inclination was 1.79 (confidence interval: 1.44, 2.23). After mutual adjustment for the 4 parameters, statistical significance for inclination still remained, with no substantial changes in the association estimates.Conclusions. This study indicates that spinal inclination is associated with future dependence in ADL among older adults.

Original languageEnglish
Pages (from-to)869-875
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume68
Issue number7
DOIs
Publication statusPublished - 2013 Jul

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Activities of Daily Living
Posture
Japan
Cohort Studies
Sacrum
Nursing Homes
Hip
Thorax
Odds Ratio
Prospective Studies
Confidence Intervals
Population

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology
  • Medicine(all)

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Spinal posture in the sagittal plane is associated with future dependence in activities of daily living : A community-based cohort study of older adults in Japan. / Kamitani, Kojiro; Michikawa, Takehiro; Iwasawa, Satoko; Eto, Norihito; Tanaka, Taichiro; Takebayashi, Toru; Nishiwaki, Yuji.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 68, No. 7, 07.2013, p. 869-875.

Research output: Contribution to journalArticle

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