Assessment of spinal posture in health exams reliably detects cognitive decline

A mass survey of citizens between the ages of 50 and 89 examined whether cognitive decline could be detected by measuring the sagittal balance of the spine based on an X-ray approach. Physicians at Shinshu University observed associations of sagittal vertical axis (SVA) anteriorization and older age with lower cognitive function. The sagittal vertical axis is the length of a horizontal line connecting the posterosuperior sacral endplate to a vertical plumb line dropped from the centroid of the C7 vertebral body (Photo 1). The further the head and neck protrude in front of the pelvis when viewed from the side (the greater the length), the more likely subjects are to exhibit symptoms of mild cognitive decline. In men, VAS was associated with cognitive decline regardless of age. In women, cognitive decline was more likely in cases with SVA equal to or greater than 70 mm, regardless of age.

Mild cognitive impairment is cognitive complaints of the person or their associates and the absence of dementia. Dementia, frailty, and bed rest can be prevented by catching mild cognitive impairment at a reversible stage in communities where expensive special testing equipment or additional medical testing time is limited for the elderly population. The first author, Hikaru Nishimura, is an occupational therapist who studies the problems faced by the elderly from a rehabilitation perspective. Physical training in the elderly could prolong the magnitude of the decline to dementia or prevent it all together.

The corresponding author, Dr. Shota Ikegami of Shinshu University, states that poor posture is a manifestation of “frailty” in older people. Hidden cognitive decline, a component of frailty, can be detected through postural screening. Elderly people from Obuse City, Nagano were examined for the mass survey and found that among Japanese elderly people, those with spinal anteriorization were more likely to have decline as well. cognitive functions. Cognitive decline was reliably detected by combining age and degree of spinal imbalance. Men with SVA ≥ 100 mm at any age, SVA ≥ 90 mm at ≥ 70 years and SVA ≥ 70 mm at ≥ 80 years were likely to have cognitive decline, while women with SVA ≥ 70 mm at any age are likely to have cognitive impairment. decline.

Nagano Prefecture has one of the highest health longevities in Japan. With this study and others, doctors hope to prevent future care needs through rehabilitation interventions for frail people discovered during screenings.

This work was supported by a grant from the Japan Orthopedics and Traumatology Research Foundation, Inc. [no. 339], the Shinshu Charitable Foundation for the Promotion of Medical Sciences, the research funding of the Japanese Society of Musculoskeletal Medicine, the project for the promotion of education, research and medical care of the Shinshu University Hospital and the Nakatomi Foundation. None of the above funding sources played a role in the design, execution, analysis, data interpretation or writing of the study.


Journal reference:

Nishimura, H. et al. (2022) Detection of cognitive decline by assessment of spinal posture in health examinations of the general elderly population. Scientific reports.


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