Gait Speed as a Predictor for Diabetes Incidence in People with or at Risk of Knee Osteoarthritis: A Longitudinal Analysis from the Osteoarthritis Initiative

Abstract

Background: This study examined the association between baseline gait speed with incident diabetes mellitus (DM) among people with or at elevated risk for knee OA. Materials and Methods: Participants from the Osteoarthritis Initiative, aged 45 to 79 years, where included. Participants with or at risk of knee OA from baseline to the 96-month visit were included. Participants with self-reported DM at baseline were excluded. DM incidence was followed over the 4-time points. Gait speed was measured at baseline using a 20-m walk test. Generalized estimating equations with logistic regression were utilized for analyses. Receiver operator characteristic curves and area under the curve were used to determine the cutoff score for baseline speed. Results: Of the 4313 participants included in the analyses (58.7% females), 301 participants had a cumulative incidence of DM of 7.0% during follow-up. Decreased gait speed was a significant predictor of incident DM (RR 0.44, p = 0.018). The threshold for baseline gait speed that predicted incident DM was 1.32 m/s with an area under the curve of 0.59 (p < 0.001). Conclusions: Baseline gait speed could be an important screening tool for identifying people at risk of incident diabetes, and the determined cutoff value for gait speed should be examined in future research.

Compensatory Responses During Slip-Induced Perturbation in Patients With Knee Osteoarthritis Compared With Healthy Older Adults: An Increased Risk of Falls?

“…Gait speed reduction has been documented as a risk factor for falls in patients with KOA ( Purser et al, 2012 ; Taş et al, 2014 ; Gill et al, 2017 ). In the current study, the gait speed of patients with KOA in Normal was significantly smaller than that of older adults, which is consistent with previous studies ( Debi et al, 2012 ; Queen et al, 2016 ; Wiik et al, 2017 ; Vennu and Misra, 2018 ; Alenazi et al, 2021 ). The difference between the groups was still present in slip_Rec1, whereas the gait speed of slip_Rec1 did not differ from the Normal gait speed within the groups.…”

“…This means that both patients with KOA and older adults are within their capabilities for speed control after a backward slip perturbation, and gait speed does not serve as an indicative indicator of their response to the perturbation but may be considered a predictor of increased fall risk in KOA patients compared to healthy older adults. Patients with KOA not only showed lower gait speed, but this also declined over time, even after controlling for BMI and other covariates ( Vennu and Misra, 2018 ; Alenazi et al, 2021 ). However, in the present study, the difference in BMI between the two groups was significant ( p = 0.001), which may have contributed to the decrease in gait speed, although no correlation analysis between the two was performed.…”

“…Gait speed is a predictor of morbidity in patients with KOA ( Alenazi et al, 2021 ); this factor is related to functional capacity in adults with mobility impairments ( Peel et al, 2013 ). Gait speed reduction has been documented as a risk factor for falls in patients with KOA ( Purser et al, 2012 ; Taş et al, 2014 ; Gill et al, 2017 ).…”

Objective performance tests assess aspects of function not captured by self-report in knee osteoarthritis

“…In a study of persons with hip OA, 44% of those with a TUG >14 ​s had a frequent near-falls, as compared with 15% of those with TUG <10 ​s [ 6 ]. Alenazi and colleagues found that lower gait speed was associated with incident diabetes mellitus in OAI participants [ 7 ]. Finally, Zeni and colleagues showed that persons with knee OA who had slower times on the TUG and a stair climbing test were more likely to undergo total knee replacement [ 8 ].…”

“…Self-report measures do not require face-to-face contact between subjects and the research team, but they may not accurately reflect the subject's true capability. Objective measures have been associated with several clinically important outcomes in persons with OA including falls, incident diabetes, and total knee replacement [ [5] , [6] , [7] , [8] ]. Several studies have examined associations between self-report measures of pain and function and objective performance tests in adults with knee OA.…”