Relationship between the occiput-wall distance and physical performance in the elderly: a cross sectional study

Background and aims: The occiput-wall distance (OWD), a measure of kyphosis, has been associated with postural instability, osteoporosis, disability and depression. The association between OWD and measures of physical performance was evaluated. Methods: Data from the Invecchiare in Chianti (InCHIANTI) study on home-dwelling people were used. People younger than 65 years and with overt disability at baseline assessment were excluded. The sample population was divided into three groups according to the OWD distribution (1st quartile: short OWD; 2nd and 3rd quartiles: medium OWD; 4th quartile: long OWD). Performance scores were expressed as the percentage of the best performance in this population. Results: 783 persons (55% women) were studied. The mean age for men was 73.8 (SD 6.34) and 75.0 (SD 6.85) for women. In men, a longer OWD was associated with reduced balance and walking speed, but not with impaired performance at the chair standing test. Overall, the association between increased OWD and reduced physical function was weak. In women, OWD was associated with a reduced walking speed, expressed as a percentage of the best performance (mean [SD]. 77% [12], 72% [14], 66% [15] in short, medium and long OWD groups, respectively), and impaired balance (mean [SD]: 97% [11], 95% [13], 90% [21] for short, medium and long OWD groups, respectively). Conclusions: Our findings suggest that OWD is an easily measurable marker of poor physical function in women. Further research should verify whether OWD predicts incident disability.