The association between walking speed from short- and standard-distance tests with the risk of all-cause mortality among adults with radiographic knee osteoarthritis: data from three large United States cohort studies

H Master; T Neogi; L F Callahan; A E Nelson; M LaValley; R J Cleveland; Y M Golightly; L M Thoma; Y Zhang; D Voinier; M B Christiansen; J T Jakiela; M Nevitt; C E Lewis; L A Frey-Law; D K White

doi:10.1016/j.joca.2020.08.009

The association between walking speed from short- and standard-distance tests with the risk of all-cause mortality among adults with radiographic knee osteoarthritis: data from three large United States cohort studies

Osteoarthritis Cartilage. 2020 Dec;28(12):1551-1558. doi: 10.1016/j.joca.2020.08.009. Epub 2020 Aug 28.

Authors

H Master¹, T Neogi², L F Callahan³, A E Nelson⁴, M LaValley⁵, R J Cleveland⁴, Y M Golightly⁶, L M Thoma⁷, Y Zhang⁸, D Voinier⁹, M B Christiansen⁹, J T Jakiela⁹, M Nevitt¹⁰, C E Lewis¹¹, L A Frey-Law¹², D K White⁹

Affiliations

¹ Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE, USA; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE, USA; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: hiral@udel.edu.
² Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA.
³ Departments of Social Medicine and Orthopedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA.
⁴ Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA.
⁵ School of Public Health, Boston University, Boston, MA, USA.
⁶ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA; Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, NC, USA.
⁷ Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁸ Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁹ Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE, USA; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE, USA.
¹⁰ Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA.
¹¹ Department of Epidemiology, University of Alabama, Birmingham, AL, USA.
¹² Department of Physical Therapy and Rehabilitation Sciences, University of Iowa, Iowa City, IA, USA.

Abstract

Objective: Adults with radiographic knee OA (rKOA) are at increased risk of mortality and walking difficulty may modify this relation. Little is known about specific aspects of walking difficulty that increase mortality risk. We investigated the association of walking speed (objective measure of walking difficulty) with mortality and examined the threshold that best discriminated this risk in adults with rKOA.

Methods: Participants with rKOA from the Johnston County Osteoarthritis Project (JoCoOA, longitudinal population-based cohort), Osteoarthritis Initiative and Multicenter Osteoarthritis Study (OAI and MOST, cohorts of individuals with or at high risk of knee OA) were included. Baseline speed was measured via 2.4-meter (m) walk test (short-distance) in JoCoOA and 20-m walk test (standard-distance) in OAI and MOST. To examine the association of walking speed with mortality risk over 9 years, hazard ratios (HR) and 95% confidence intervals (CI) were calculated from Cox regression models adjusted for potential confounders. A Maximal Likelihood Ratio Chi-square Approach was utilized to identify an optimal threshold of walking speed predictive of mortality.

Results: Deaths after 9 years of follow-up occurred in 23.3% (290/1244) of JoCoOA and 5.9% (249/4215) of OAI + MOST. Walking 0.2 m/s slower during short- and standard-distance walk tests was associated with 23% (aHR [95%CI]; 1.23 [1.10, 1.39]) and 25% (1.25 [1.09, 1.43]) higher mortality risk, respectively. Walking <0.5 m/s on short-distance and <1.2 m/s standard-distance walk tests, best discriminated those with and without mortality risk.

Conclusion: Slower walking speed measured via short- and standard-distance walk tests was associated with increased mortality risk in adults with rKOA.

Keywords: Arthritis; Death; Gait speed; Performance-based measures; Physical function.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Cohort Studies
Female
Humans
Longitudinal Studies
Male
Middle Aged
Mortality
Osteoarthritis, Knee / physiopathology*
United States
Walking Speed / physiology*

Abstract

Publication types

MeSH terms

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