All the measures of comorbidity predicted death and BADL disability in older community dwellers. DC, CCI, and ICED performed better than GIC and CDS. Physical performance measures are strong, independent contributors to the prediction of these outcomes.

OBJECTIVES:To assess whether kyphosis is associated with ventilatory dysfunction in older community dwellers. DESIGN: Cross-sectional study. SETTING: The unselected population of Dicomano, Italy aged !65 years. PARTICIPANTS: A total of 323 nonheart failure participants underwent clinical evaluation for the presence of kyphosis and spirometry. The severity of kyphosis was estimated from the difference between standing stature and knee-height-derived stature and from the occiput-wall distance. MEASUREMENTS: Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and prevalence of obstructive and restrictive ventilatory pattern. RESULTS: The 130 kyphotic participants (40.2%) had an adjusted 2.5 prevalence odds ratio (POR) for dyspnea (95% confidence interval (CI) 5 1.1-5.8). FVC% and FEV1% were lower in the presence of kyphosis (Po.01); their deficit was proportional to kyphosis severity. The ventilatory dysfunction was underestimated when reference spirometric parameters were calculated based on standing stature, compared with knee-height derived stature. Of the kyphotic participants, 56.2%, 26.9%, and 16.9% had spirometric normal, obstructive, and restrictive patterns, respectively. Kyphosis was associated with a restrictive (adjusted POR 5 2.3, 95% CI 5 1.1-4.8; P 5.021) and an obstructive ventilatory pattern (adjusted POR 5 3.3, 95% CI 5 1.7-6.5; Po.001). CONCLUSION: In unselected older persons, kyphosis is associated with dyspnea and ventilatory dysfunction of a restrictive and an obstructive type. Kyphosis should be included in the differential diagnosis of dyspnea and ventilatory dysfunction in the elderly. J Am Geriatr Soc 52: 909-915, 2004.