Examining posture during a health check could identify cognitive decline.
The question of whether cognitive decline may be identified by sagittal spinal balance assessment based on a radiological approach was investigated via a large-scale survey of persons aged 50 to 89 years. Shinshu University researchers discovered links between sagittal vertical axis (SVA) anteriorization and older age and worse cognitive performance. The distance between the posterior superior sacral end plate to a vertical plumbline dropped from the centroid of the C7 vertebral body is known as the sagittal vertical axis.
Subjects are more likely to have signs of moderate cognitive decline the more the head and neck protrude in front of the pelvis when seen from the side (the greater the length). In men, the SVA was linked to age-independent cognitive decline. Cognitive decline was more prevalent in females with SVA equal to or more than 70mm, regardless of age.
Mild cognitive impairment is defined as cognitive complaints from the person or others but no dementia. In areas where costly specialized testing equipment or additional medical testing time is restricted for the senior population, dementia, frailty, and bedridden condition may be avoided by detecting moderate cognitive impairment at a reversible stage.
Hikaru Nishimura, the first author, is an occupational therapist who studies issues encountered by the elderly from a rehabilitation viewpoint. In older adults, exercise training may lessen or even stop the progression of dementia.
Corresponding author Doctor Shota Ikegami of Shinshu University states that poor posture is a manifestation of “frailty” in the elderly. Hidden cognitive decline, a component of frailty can be detected by posture screening. Older adults in the town of Obuse, Nagano were examined for the mass survey. It was found that in Japanese older adults, those who exhibited anteriorization of the spine were more likely to also have cognitive function decline.
Cognitive decline was reliably detected by combining age and the degree of spinal imbalance. Males 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 females with SVA ≥ 70 mm at any age are likely to have cognitive decline.
The prefecture of Nagano boasts some of the highest health longevity in Japan. With this study and others, doctors hope to prevent future need for care through rehabilitation interventions for frailty found during screenings.
Reference: “Detection of cognitive decline by spinal posture assessment in health exams of the general older population” by Hikaru Nishimura, Shota Ikegami, Masashi Uehara, Jun Takahashi, Ryosuke Tokida, and Hiroyuki Kato, 19 May 2022, Scientific Reports.
The study was funded by the Japan Orthopaedics and Traumatology Research Foundation, Inc., the Shinshu Public Utility Foundation for Promotion of Medical Sciences, the Japanese Society for Musculoskeletal Medicine, the Shinshu University Hospital, and the Nakatomi Foundation.