• Tae Woo Kim, Jae Keun Oh, Ji Yeon Lee, Samuel K Cho, Seong Bae An, Hyeong Seok Jeon, Hyung Cheol Kim, Kwang Joon Kim, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Yoon Do Heum DH Department of Neurosurgery, Spine and Spinal Cord Institute, College of Medicine, Yonsei University, Seoul, Korea., Chang Oh Kim, and Yoon Ha.
• Department of Neurosurgery, Spine and Spinal Cord Institute, College of Medicine, Yonsei University, Seoul, Korea; Department of Neurosurgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
• World Neurosurg. 2020 Jun 1; 138: e759-e766.

ObjectiveTo assess the relationship between frailty, activities of daily living (ADL), instrumental ADL (IADL), and sagittal spinopelvic parameters in the elderly.MethodsTo compare the characteristics based on the FRAIL scale status (robust, prefrail, frail), continuous variables were analyzed using ANOVA with Tukey post hoc tests, and categorical variables were analyzed using χ2 and Fisher's exact test. Multivariate linear regression was used to investigate cross-sectional association between sagittal alignment and FRAIL status.ResultsComparison analysis of the 3 groups (robust, prefrail, frail) demonstrated that frailty scale had significant correlations with T1 pelvic angle (T1PA, P = 0.019), pelvic tilt (PT, P = 0.004), pelvic incidence minus lumbar lordosis (PI-LL, P = 0.004) and ADL (P = 0.017). Multiple regression analysis that controlled for confounding factors confirmed the correlations between frailty scale and spinopelvic parameters (C7 sagittal vertical axis [SVA], B = 17.49, P = 0.028; T1PA, B = 4.83, P = 0.029; PT, B = 4.62, P = 0.003; PI-LL value, B = 7.11, P = 0.005). In addition, the ADL was associated with T1PA (B = 4.06, P = 0.006); whereas the IADL was correlated with C7 SVA (B = 11.38, P = 0.005), T1PA (B = 3.36, P = 0.003), and PI-LL (B = 3.13, P = 0.018).ConclusionsHigher frailty score was associated with higher grades of sagittal spinopelvic malalignment and ADL in the elderly. Furthermore, higher ADL and IADL scores were associated with higher grades of sagittal spinopelvic malalignment. Frailty, ADL, IADL, and sagittal spinopelvic parameters were closely related to each other in the elderly.Copyright © 2020 Elsevier Inc. All rights reserved.

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