Citation

Kirkness CS, Ren J. Phys. Ther. 2015; 95(7): 955-965.

Affiliation

J. Ren, PhD, Department of Internal Medicine, Center for Outcomes Research, University of Illinois College of Medicine at Peoria.

Copyright

(Copyright © 2015, American Physical Therapy Association)

DOI

10.2522/ptj.20140028

PMID

25655879

Abstract

BACKGROUND: Onset of disability, risk of future falls, frailty, functional decline, and mortality are strongly associated with a walking speed (WS) <1.0m/s.

OBJECTIVES: To determine if walking speed (WS <1.0m/s) differed between community-dwelling African-American (AA) and White American (WA) adult women with osteoarthritis symptoms. Further the study examines whether racial differences in walking speed can be attributed to age, obesity, socioeconomic factors, disease severity and comorbidity.

DESIGN: Cross-sectional SETTING: Community dwelling adults recruited from: Baltimore, MD; Columbus, OH; Pittsburgh, PA; and Pawtucket, RI. PARTICIPANTS: Participants were 2648 women (23% AA) age 45-79 years with baseline WS (Self-selected 20m) in the Osteoarthritis Initiative (OAI) study. MEASUREMENTS: Mixed-effects logistic regression models examined racial differences in WS (<1.0m/s vs. ≥1.0m/s) adjusting for demographics, socioeconomic factors, disease severity and comorbidity.

RESULTS: WS was significantly (p<0.001) slower for AA than WA women (mean WS 1.19 vs 1.33 m/s). The prevalence of WS <1.0 m/s in this cohort of middle-aged women was 9%; 50% of the women with WS <1.0 m/s were under 65 years of age. Women walking <1.0 m/s had lower socioeconomic values, higher disease severity and higher prevalence of obesity and comorbidities compared to those walking ≥ 1.0 m/s. After controlling for these covariates, AA women were 3 times (OR=2.9, 95%CI: 2.0-4.1) more likely to have WS <1.0m/s than WA women. LIMITATIONS: The study design makes it impossible to know if walking speed <1.0m/s in women ≥ 45 years old is a predictor of future poor health outcomes.

CONCLUSION: In this study, race is independently associated with WS <1.0m/s among community dwelling women with or at risk for OA, with AA women having 3 times the risk of slow walking compared to WA women. In an older population this finding would indicate that middle-aged AA women are at increased risk of poor health outcomes. Further longitudinal evaluations are needed to confirm the long-term health outcomes in a middle-age population and to establish the utility of WS as a useful tool to identify middle-age women at high risk of poor health.

Language: en