Our results suggest that

treating hyperkyphosis may help preserve mobility, although further work is needed to determine whether reducing hyperkyphosis alone can slow mobility decline. Limitations The primary limitation of our study is the cross-sectional nature of this analysis, which does not allow us to infer causality. The strengths of our study include SB525334 ic50 the large sample size and measurement of kyphosis angle, Timed Up and Go performance times, and potential confounders of their association, including BMD, grip strength, and vertebral fracture. Furthermore, using an objective measure of physical function that is a validated predictor of increased fall risk allows us to demonstrate a more clinically meaningful outcome rather than merely report a significant association. Finally, we were able to disentangle the ill effects of spinal osteoporosis from that of hyperkyphosis. Until recently, many have NVP-HSP990 cost assumed that hyperkyphosis is simply a reflection of underlying vertebral fractures; our results suggest that hyperkyphosis itself is deserving of more clinical attention. Conclusions Kyphosis angle is independently associated with decreased mobility, which

is in turn correlated with increased fall risk. Hyperkyphosis may be a useful clinical marker signaling the need for evaluation of vertebral fracture and falling risk. While exercises and bracing that can reduce hyperkyphosis Idoxuridine are available, further work is needed to show that reducing hyperkyphosis helps preserve mobility and reduces falling risk. Acknowledgement All of the authors had access to the data and participated in writing the manuscript. Conflicts of interest None Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. References 1. Balzini L, Vannucchi L, Benvenuti F et al (2003) Clinical characteristics of flexed posture in elderly women. J Am Geriatr Soc 51(10):1419–1426CrossRefPubMed

2. Sinaki M, Brey RH, Hughes CA, Larson DR, Kaufman KR (2005) Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int 16(8):1004–1010CrossRefPubMed 3. Ryan SD, Fried LP (1997) The impact of kyphosis on daily functioning. J Am Geriatr Soc 45(12):1479–1486PubMed 4. Lyles KW, Gold DT, Shipp KM, Pieper CF, Martinez S, Mulhausen PL (1993) Association of osteoporotic vertebral compression fractures with impaired functional ARRY-438162 status. Am J Med 94(6):595–601CrossRefPubMed 5. Kado DM, Huang MH, Barrett-Connor E, Greendale GA (2005) Hyperkyphotic posture and poor physical functional ability in older community-dwelling men and women: the Rancho Bernardo study. J Gerontol A Biol Sci Med Sci 60(5):633–637PubMed 6.