As reported by MedScape Today, March 25, 2010.

Height Loss in Older Women May Signal Vertebral Fracture

By Megan Brooks

When asked by their physician how tall they currently are, postmenopausal women often overestimate their height by an average of 2.4 cm, a new study shows.

The study also confirms that loss of height with advancing age may indicate vertebral fracture, making accurate information on height important, researchers point out in an article published online March 22 in the Canadian Medical Association Journal.

"Thus, general practitioners need to measure the height of their postmenopausal patients and not rely on reported estimates," Karine Briot, MD, PhD, from the Department of Rheumatology, Hôpital Cochin in Paris, France, and colleagues conclude.

This study shows that older peoples' estimates of height are "not particularly accurate," George A. Kuchel, MD, who was not involved in the study, noted in a telephone interview with Medscape Ob/Gyn & Women's Health. "It's interesting because they tend to underestimate how much they lose. I think this has to do with how we perceive ourselves as we age. We view ourselves often as being much younger than we actually are and much more functional than we are," added Dr. Kuchel, who is director of the University of Connecticut Center on Aging, located in Farmington.

In their observational study, Dr. Briot and colleagues compared reported and measured loss of height in 8610 postmenopausal women (mean age, 70.9 years) who were patients of 1779 randomly selected general practitioners in France. Participating physicians collected data on demographic and clinical variables and asked the women to recall their tallest height in early adulthood and to estimate their current height. Their actual height was measured using an electronic stadiometer.

According to the researchers, the average current self-reported height was 2.1 cm (standard deviation, 2.5 cm) lower than the tallest recalled height from early adulthood, and 2.4 cm (standard deviation, 2.6 cm) lower than the actual measured height.

Average height loss since early adulthood was 4.5 cm, with 70.9% of the women having a loss of at least 3 cm and 27.1% having a loss of at least 6 cm.

Radiographs or radiologist's reports showed vertebral fracture in 12.7% of women, scoliosis in 23.1%, thoracic kyphosis in 24.2%, and spinal osteoarthritis in 50.9%.

The risk for existing vertebral fracture was significantly higher in women with a height loss of at least 4 cm, "a threshold similar to the one recommended by the International Society for Clinical Densitometry," the authors note.

"With respect to the presence of vertebral fracture on the radiologist's report, a threshold of 4 cm of height loss had a sensitivity of 74% and a specificity of 49%; a threshold of 6 cm had a sensitivity of 47% and a specificity of 76%," the authors further report. In multivariable analysis, the best predictors of vertebral fracture were older age, a history of height loss of at least 4 cm, back pain, and previous nonvertebral fracture.

Loss of height is a "clinically important issue," Dr. Kuchel said. "It's been associated with declines in mobility associated with increased mortality, in addition to poor physical function, osteoporotic fractures, and pain. The thought is that if someone has lost height, you can take the next step and do X-rays and/or [evaluate] bone mineral density and institute treatment for osteoporosis and address risk factors for falls."

The study was supported by an unrestricted grant from Merck. Dr. Briot and 2 coauthors received honoraria from Merck for participating in the study. Dr. Kuchel has disclosed no relevant financial relationships.