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Losing weight in old age is a major risk factor for hyperkyphosis



DOI:10.1038/bonekey.2012.215

Hyperkyphosis, which causes an obvious 'humpback' appearance in old age, affects up to four in ten older women, yet it is poorly characterized. Kado et al. performed a retrospective cohort study of 1196 women from the Study of Osteoporotic Fractures, following them for 15 years to assess risk factors for kyphosis occurrence and progression.

Women assessed at baseline showed a mean kyphosis angle of 44.7 degrees, which had increased to 51.8 degrees at the end of the study period. Kyphosis occurrence correlated with a strong family history of the condition, low bone mineral density (BMD), smoking, obesity, degenerative disc disease and prevalent vertebral fractures.

Progression over the study period was independently associated with both prevalent and incident vertebral fractures, low BMD and further loss of bone density, lower body weight and loss of weight. A one degree increase in kyphosis correlated with each 5 kg of body weight lost.

Editor's comment: This study confirms previous observations showing that as older people lose weight, they lose muscle preferentially over fat. As core muscle support reduces, kyphosis can be expected to progress. Possible prevention and treatment approaches include reducing the rate of bone loss and encouraging older people not to lose lean mass, or even to gain it using diet and exercise.


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