Diffuse Idiopathic Skeletal Hyperostosis ( DISH ) and Impaired Physical Function: The Rancho Bernardo Study

Objectives Investigate associations of diffuse idiopathic skeletal hyperostosis ( DISH ) with self‐reported and measured physical function in older adults. Design Cross‐sectional analyses of data collected in 1992–96 from a longitudinal cohort. Setting: Research clinic within a community. Participants Community‐dwelling men (n = 630) and women (n = 961), mean age 71.5 years ( SD = 10.8), from the Rancho Bernardo Study. Measurements DISH assessed from lateral thoracic and lumbar spine radiographs; self‐reported difficulty bending over to the floor, walking 2–3 level blocks, or climbing 1 flight of stairs; performance‐based measures of grip strength and chair‐stand testing (ability to stand up and sit down in a chair 5 times without using chair arms). Results DISH was present in 25.6% of men and 5.5% of women. In age and sex‐adjusted models, those with DISH had 1.72‐fold increased odds (95% CI : 1.13, 2.62) of self‐reported difficulty bending; this remained significant after further adjustment for Cobb angle, weight, stroke, arthritis, and exercise, OR = 1.69, (95% CI : 1.07, 2.66). In fully adjusted multivariate models, those with DISH had worse grip strength, −1.08 kg, P = .01, but did not differ from those without DISH on walking or climbing stairs. In sex‐stratified, fully adjusted models, among men only, those with DISH were 2.17‐times (95% CI : 1.04, 4.52) more likely to be unable to complete 5 chair stands without using their arms. Conclusions DISH was less prevalent in women but affected almost one‐quarter of older white men. People with DISH are more likely to experience physical functional impairment, suggesting that DISH has clinical correlations and is not an incidental radiographic finding.