Hyperkyphosis in older adults is an important, common problem, associated with significant disability, morbidity, and mortality, and will increase with the aging of the population. Despite the public health burden, there are no guidelines for prevention, treatment, or management even though there is increasing evidence for effective interventions to reduce progression and even improve thoracic kyphosis. A critical barrier to developing efforts to prevent and treat hyperkyphosis is a lack of information on (1) the natural history of progression of kyphosis in women and men throughout adulthood, (2) the spinal features that contribute to progression, and (3) the adverse health outcomes associated with progression of kyphosis. This project is highly significant, because the 3 aims of this study directly address this gap in knowledge. We propose to conduct a longitudinal study of 6-year change in thoracic kyphosis, or Cobb angle, in 2,000 women and men in the Framingham Study. First, we will determine the contribution of baseline age, baseline kyphosis angle, and prevalent vertebral fracture status to progression of kyphosis in women and men. Second, we will determine the contribution of declines in intervertebral disc height, declines in spinal muscle mass, progression of facet joint osteoarthritis, and incidence of vertebral fracture to progression of kyphosis in women and men. Third, we will determine the association between progression of kyphosis and declines in lung function (assessed by spirometry) and physical function (timed walk, Nagi and Rosow-Breslau scales) in women and men. This project leverages comprehensive, high quality, clinical data, previously collected in a well-characterized community-based study, to fill a critical gap in knowledge required to develop efforts to prevent and treat hyperkyphosis and avoid further adverse health outcomes. The research team represents expertise in epidemiology, biomechanics and clinical medicine necessary to investigate this significant, complex condition. Our findings have a high likelihood of significantly impacting clinical practice and public health. By identifying factors that contribute to progression of kyphosis and adverse health outcomes associated with progression of kyphosis, this study will inform efforts to identify individuals at high risk for progression and candidates for prevention, treatment, and management to avoid further disease burden.

Public Health Relevance

Hyperkyphosis (forward thoracic curvature) in older adults is an important, common problem, associated with significant disability, morbidity, and mortality, and will increase with the aging of the population. The purpose of this project is to determine the natural history, risk factors and clinical outcomes of hyperkyphosis. A greater understanding of the factors that contribute to progression of kyphosis will help lead to interventions to prevent and treat this complex condition.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG041658-05
Application #
8856454
Study Section
Neurological, Aging and Musculoskeletal Epidemiology (NAME)
Program Officer
Joseph, Lyndon
Project Start
2011-09-30
Project End
2017-05-31
Budget Start
2015-06-01
Budget End
2017-05-31
Support Year
5
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Hebrew Rehabilitation Center for Aged
Department
Type
DUNS #
030832075
City
Boston
State
MA
Country
United States
Zip Code
Allaire, B T; Lu, D; Johannesdottir, F et al. (2018) Prediction of incident vertebral fracture using CT-based finite element analysis. Osteoporos Int :
Johannesdottir, F; Allaire, B; Anderson, D E et al. (2018) Population-based study of age- and sex-related differences in muscle density and size in thoracic and lumbar spine: the Framingham study. Osteoporos Int 29:1569-1580
Kaiser, Jarred; Allaire, Brett; Fein, Paul M et al. (2018) Correspondence between bone mineral density and intervertebral disc degeneration across age and sex. Arch Osteoporos 13:123
Jarraya, Mohamed; Guermazi, Ali; Lorbergs, Amanda L et al. (2018) A longitudinal study of disc height narrowing and facet joint osteoarthritis at the thoracic and lumbar spine, evaluated by computed tomography: the Framingham Study. Spine J 18:2065-2073
Lorbergs, Amanda L; O'Connor, George T; Zhou, Yanhua et al. (2017) Severity of Kyphosis and Decline in Lung Function: The Framingham Study. J Gerontol A Biol Sci Med Sci 72:689-694
Liu, Ching-Ti; Broe, Kerry E; Zhou, Yanhua et al. (2017) Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study. J Bone Miner Res 32:143-150
Allaire, Brett T; DePaolis Kaluza, M Clara; Bruno, Alexander G et al. (2017) Evaluation of a new approach to compute intervertebral disc height measurements from lateral radiographic views of the spine. Eur Spine J 26:167-172
Lorbergs, Amanda L; Murabito, Joanne M; Jarraya, Mohamed et al. (2017) Thoracic Kyphosis and Physical Function: The Framingham Study. J Am Geriatr Soc 65:2257-2264
Nielson, Carrie M; Liu, Ching-Ti; Smith, Albert V et al. (2016) Novel Genetic Variants Associated With Increased Vertebral Volumetric BMD, Reduced Vertebral Fracture Risk, and Increased Expression of SLC1A3 and EPHB2. J Bone Miner Res 31:2085-2097
Yau, Michelle S; Demissie, Serkalem; Zhou, Yanhua et al. (2016) Heritability of Thoracic Spine Curvature and Genetic Correlations With Other Spine Traits: The Framingham Study. J Bone Miner Res 31:2077-2084