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Research ArticleOsteoarthritis

Does the 1-year Decline in Walking Speed Predict Mortality Risk Beyond Current Walking Speed in Adults With Knee Osteoarthritis?

Hiral Master, Tuhina Neogi, Michael LaValley, Louise M. Thoma, Yuqing Zhang, Dana Voinier, Meredith B. Christiansen and Daniel K. White
The Journal of Rheumatology February 2021, 48 (2) 279-285; DOI: https://doi.org/10.3899/jrheum.200259
Hiral Master
1H. Master, PT, PhD, MPH, Department of Physical Therapy, College of Health Sciences, University of Delaware, Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, and Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;
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Tuhina Neogi
2T. Neogi, MD, PhD, Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts;
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Michael LaValley
3M. LaValley, PhD, School of Public Health, Boston University, Boston, Massachusetts;
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Louise M. Thoma
4L.M. Thoma, PT, PhD, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
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Yuqing Zhang
5Y. Zhang, PhD, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;
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Dana Voinier
6D. Voinier, PT, DPT, M.B. Christiansen, PT, PhD, D.K. White, PT, ScD, MSc, Department of Physical Therapy, College of Health Sciences, University of Delaware and Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, Delaware, USA.
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Meredith B. Christiansen
6D. Voinier, PT, DPT, M.B. Christiansen, PT, PhD, D.K. White, PT, ScD, MSc, Department of Physical Therapy, College of Health Sciences, University of Delaware and Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, Delaware, USA.
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Daniel K. White
6D. Voinier, PT, DPT, M.B. Christiansen, PT, PhD, D.K. White, PT, ScD, MSc, Department of Physical Therapy, College of Health Sciences, University of Delaware and Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, Delaware, USA.
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  • For correspondence: dkw@udel.edu
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Abstract

Objective. To investigate whether walking speed at 1 timepoint, decline over the past 12 months, or both predict mortality risk over 11 years in adults with, or at risk of, knee osteoarthritis (OA).

Methods. Using the data from the Osteoarthritis Initiative, we defined slow versus adequate walking speed as walking < 1.22 versus ≥ 1.22 m/s on a 20m walk test during the 12-month follow-up visit. We defined meaningful decline (yes/no) as slowing ≥ 0.08 m/s over the past year. At the 12-month visit, we classified adequate sustainers as those with adequate walking speed and no meaningful decline, slow sustainers as slow walking speed and no meaningful decline, adequate decliners as adequate walking speed and meaningful decline, and slow decliners as slow walking speed and meaningful decline. Mortality was recorded over 11 years. To examine the association of walking speed with mortality, HR and 95% CI were calculated using Cox regression, adjusted for potential confounders.

Results. Of 4229 participants in the analytic sample (58% female, age 62 ± 9 yrs, BMI 29 ± 5 kg/m2), 6% (n = 270) died over 11 years. Slow sustainers and slow decliners had 2-times increased mortality risk compared to adequate sustainers (HR 1.96, 95% CI 1.44–2.66 for slow sustainers, and HR 2.08, 95% CI 1.46–2.96 for slow decliners). Adequate decliners had 0.43 times the mortality risk compared with adequate sustainers (HR 0.57, 95% CI 0.32–1.01).

Conclusion. In adults with, or at risk of, knee OA, walking slower than 1.22 m/s in the present increased mortality risk, regardless of decline over the previous year.

Key Indexing Terms:
  • decline
  • knee osteoarthritis
  • mortality
  • walking speed
  • Accepted for publication April 28, 2020.
  • Copyright © 2021 by the Journal of Rheumatology
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Does the 1-year Decline in Walking Speed Predict Mortality Risk Beyond Current Walking Speed in Adults With Knee Osteoarthritis?
Hiral Master, Tuhina Neogi, Michael LaValley, Louise M. Thoma, Yuqing Zhang, Dana Voinier, Meredith B. Christiansen, Daniel K. White
The Journal of Rheumatology Feb 2021, 48 (2) 279-285; DOI: 10.3899/jrheum.200259

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Does the 1-year Decline in Walking Speed Predict Mortality Risk Beyond Current Walking Speed in Adults With Knee Osteoarthritis?
Hiral Master, Tuhina Neogi, Michael LaValley, Louise M. Thoma, Yuqing Zhang, Dana Voinier, Meredith B. Christiansen, Daniel K. White
The Journal of Rheumatology Feb 2021, 48 (2) 279-285; DOI: 10.3899/jrheum.200259
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Keywords

decline
KNEE OSTEOARTHRITIS
MORTALITY
walking speed

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Keywords

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