The controlled study of diffuse idiopathic skeletal hyperostosis for the assessment of physical function in elderly populations.

BACKGROUND

Diffuse idiopathic skeletal hyperostosis (DISH) is associated with increasing age, obesity, and diabetes mellitus. However, little is known about the clinical impacts of DISH on physical function and spinal deformity in elderly populations. The purpose of this study was to elucidate the influence of DISH on physical function, spinal deformity, and health-related quality of life (HRQOL) in elderly populations.

METHODS

We enrolled 504 volunteers (203 men and 301 women, mean age 74.0 years). Height, weight, body mass index (BMI), blood pressure, grip strength, one-leg standing time, sit-and-reach, functional reach, and bone mineral density (BMD) were measured. Using whole spine standing X-rays, the prevalence, location, and numbers of fused vertebra of DISH and spinopelvic parameters were measured. HRQOL measures, including the Oswestry Disability Index and the EuroQuol-5D were also obtained. We compared DISH subjects with control subjects of age and sex matching. We compared DISH subjects in the thoracic spine (T-DISH) to those in the thoraco-lumbar spine (TL-DISH).

RESULTS

DISH occurred more frequently in men (14.3%) than in women (4.3%). The mean age was significantly higher of subjects with DISH than of those without DISH. The mean number of fused vertebra by DISH was 5.5 ± 1.5, and T-DISH was observed in 57% cases. DISH group showed greater body weights, BMIs, blood pressures, and BMD in the lumbar spine compared to the control group. No inter-group differences were observed in physical function, HRQOL and spinopelvic parameters. Subjects with TL-DISH had significantly lower values of sit-and-reach and functional reach than those with T-DISH.

CONCLUSIONS

Subjects with DISH showed greater body weights, BMIs, blood pressures, and BMD compared to age- and sex-matched controls, while physical function, spinal alignment, and HRQOL were comparable between groups.