Association Between Hyperkyphosis and Depressive Symptoms: Insights from a Cross-Sectional Study of Chinese Older Adults

Background and aims: Previous studies in Western countries have yielded controversial results regarding the relationship between hyperkyphosis and depressive symptoms. This study aims to examine and further confirm this association in Chinese older adults using representative national samples. Methods: This cross-sectional study was conducted with 5,846 Chinese older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The status of hyperkyphosis was assessed through interviewer observation within a structured questionnaire. Depressive symptoms were evaluated using a concise 2-item self-report screening instrument. The association was estimated using odds ratios (OR) from logistic regression models, controlled for potential confounders. Results: 1,936 participants (33.1%) were classifiesd as having hyperkyphosis. Logistic regression models observed that those reporting having hyperkyphosis had a higher risk of depressive symptoms [odds ratios (OR) 1.20, 95% CI 1.03-1.39]. Stratified analyses were performed based on sex, age, residence, education, occupation, income, and marital status to investigate subgroup-specific associations and showed significant different modifiers. These results were consistently observed across two sensitivity analyses, highlighting the reliability of our findings. Conclusion: Our findings indicate that hyperkyphosis significantly impacts the risk of depressive symptoms in Chinese older adults. Future research should further explore the underlying mechanisms and potential intervention strategies to mitigate the risk of depressive symptoms in individuals with hyperkyphosis.