Evidence map›Paper›PMID 36307923›Full record

ArticleJournal of the American Geriatrics Society2023

Hyperkyphosis and mortality risk in older men: The osteoporotic fractures in men study.

Alexandra Cours, Mei-Hua Huang, Howard Fink, Kristine E Ensrud, John T Schousboe, Wendy Katzman, Diane Schneider, Nancy E Lane, Peggy Cawthon, Deborah M Kado

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 1 country.

Alexandra CoursDepartment of Medicine, Stanford University, Stanford, California, USA.ORCID 0000-0002-3346-3058
Mei-Hua HuangDivision of Geriatrics, University of California, Los Angeles, California, USA.
Howard FinkGeriatric Research Education & Clinical Center, Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.
Kristine E EnsrudCenter for Care Delivery and Outcomes Research, Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.ORCID 0000-0002-9069-3036
John T SchousboePark Nicollet Clinic at HealthPartners Institute, HealthPartners Inc., Minneapolis, Minnesota, USA.
Wendy KatzmanDepartment of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA.
Diane SchneiderUniversity of California, San Diego, California, USA.
Nancy E LaneDivision of Rheumatology, University of California, Davis, California, USA.
Peggy CawthonCalifornia Pacific Medical Center Research Institute, San Francisco, California, USA.
Deborah M KadoDepartment of Medicine, Stanford University, Stanford, California, USA.
Geriatric Research Education and Clinical Center · USUniversity of Minnesota · USCalifornia Pacific Medical Center · USStanford University · USUniversity of California, Davis · USUniversity of California, Los Angeles · USUniversity of California San Diego · USUniversity of California, San Francisco · US

Funding

Oregon Clinical and Translational Research InstituteUL1TR000128 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI ELLISON, DAVID H · 2012 to 2015
$28.7M
Osteoporotic Fractures in Men (MrOS) - San Francisco Coordinating CenterU01AR066160 · NIAMS · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI CUMMINGS, STEVEN RON · 2013 to 2017
$9.3M
Osteoporotic Fractures in Men (MrOS) - MinneapolisU01AG042145 · NIA · UNIVERSITY OF MINNESOTA · PI ENSRUD, KRISTINE · 2013 to 2019
$5.3M
Osteporotic Fractures in Men (MrOS)- Admin CenterU01AG027810 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2006 to 2017
$5.1M
Osteoporotic Fractures in Men (MrOS) - PortlandU01AG042124 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2013 to 2019
$3.0M
Osteoporatic Fractures in Men (MrOS)U01AG042168 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI KADO, DEBORAH · 2013 to 2017
$3.0M
Osteoporotic Fractures in Men (Mr. Os) Palo AltoU01AG042143 · NIA · STANFORD UNIVERSITY · PI STEFANICK, MARCIA L. · 2013 to 2017
$3.0M
Osteoporotic Fractures in Men (Mr.OS)U01AG042139 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CAULEY, JANE ANN · 2013 to 2017
$2.9M
Osteoporotic Fractures in Men_MrOS Renewal_BirminghamU01AG042140 · NIA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SHIKANY, JAMES M · 2013 to 2019
$2.7M
BIOLOGICAL AND STRUCTURAL PREDICTORS OF KYPHOSIS PROGRESSION IN OLDER MENR01AR060828 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI KADO, DEBORAH · 2011 to 2013
$1.0M
Causes and Consequences of Hyperkyphosis in Older WomenR01AG024246 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KADO, DEBORAH · 2004 to 2007
$978k
Causes and Consequences of Hyperkyphosis in Older PersonsR56AG024246 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KADO, DEBORAH · 2009 to 2009
$395k
NCATS NIH HHS UL1 TR000128NIAMS NIH HHS R01 AR060828NIAMS NIH HHS U01 AR066160NIA NIH HHS R01 AG024246NIA NIH HHS R56 AG024246NIA NIH HHS U01 AG027810NIA NIH HHS U01 AG042124NIA NIH HHS U01 AG042139NIA NIH HHS U01 AG042140NIA NIH HHS U01 AG042143NIA NIH HHS U01 AG042145NIA NIH HHS U01 AG042168
6 · The paper itself

Abstract

introductionHyperkyphosis commonly affects older people but is not widely acknowledged as a clinically actionable problem, especially in men. There are several techniques to quantify kyphosis including the blocks and Cobb angle measurements. This study includes both kyphosis measures to investigate whether older men with accentuated kyphosis may be at increased mortality risk.

methodsMen aged ≥65 years (N = 5994) were recruited to participate in the MrOS prospective cohort study from 2000 to 2002 (baseline). Our primary cohort included 2931 enrollees (mean age 79.3 years; SD 5.2) who underwent blocks-measured kyphosis from 2006 to 2009. Our secondary cohort included 2351 participants who underwent radiographic Cobb angle measurements at baseline. Cox proportional hazards analyses were used to determine association between kyphosis and all-cause mortality while adjusting for prevalent radiographic vertebral fractures, bone mineral density, incident fractures, gait speed, timed chair stands, self-reported health, alcohol use, medical co-morbidities, and physical activity.

resultsDuring a mean follow-up of 8.3 (SD 3.2) years, 1393 participants died in the primary cohort. In this group, compared to men with 0-1 block kyphosis, increasing blocks-measured kyphosis was associated with increased mortality (HR: 1.26-1.53, p trend <0.001). With addition of prevalent vertebral fracture to adjusted models, the association remained significant in participants with severe kyphosis (3+ blocks-measured). Similarly, with addition of chair stand performance the association remained significant for 4+ blocks kyphosis. Walking speed did not attenuate the association of kyphosis and mortality. In the secondary cohort, there were no significant associations between radiographic Cobb angle kyphosis and mortality.

conclusionsIncreasing blocks-measured kyphosis was associated with a greater risk of mortality in older men, indicating that hyperkyphosis identified on physical exam should be considered a clinically significant finding that may warrant further evaluation and treatment.

Indexed as

KyphosisOsteoporotic FracturesSpinal FracturesAgedBone DensityHumansMaleProspective Studieshyperkyphosismortality

Identifiers

PMID36307923
PMCPMC9957917
OpenAlexW4307515245

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.