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

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.