Relationship between frequent knee pain, obesity, and gait speed in older adults: data from the Osteoarthritis Initiative

Abstract

Background: Knee pain (KP) causes gait difficulties in older adults and is associated with slow gait speed (GS). Obesity has negative effects on health. GS is an important indicator of health, well-being, and mean life span in older adults and is a strong predictor of future disability and mortality. The relationship between frequent KP, obesity, and GS in older adults remains unclear. Therefore, the present study aimed at examining the relationship between baseline frequent KP and obesity status on GS over time. We hypothesized that frequent KP, obesity, or both would be associated with decreased GS over time. Methods:The data from the Osteoarthritis Initiative were used for this 6-year longitudinal cohort study. We studied 3,118 adults aged between 45 years and 79 years. We grouped the participants into the following four categories according to KP frequency and obesity status at baseline: 1) no KP and nonobese, 2) frequent KP and nonobese, 3) no KP and obese, and 4) frequent KP and obese. GS measurements were based on a 20 m walking test timed using a stopwatch; testing was performed at baseline and over a 6-year follow-up period. Walk pace (m/sec) was calculated as the average pace over two trials conducted at clinic visits. General linear mixed models were used to examine the relationships between frequent KP, obesity, and GS. Results: After adjusting for all covariates, at baseline, all the nonobese group with frequent KP (β=−0.06, 95% confidence interval [CI]: −0.07 to −0.04), the obese group with no KP (β=−0.07, 95% CI: −0.1 to −0.04), and the obese group with frequent KP (β=−0.08, 95% CI: −0.1 to −0.05) exhibited decreased GS compared with the nonobese and no KP group. However, the associations between frequent KP, obesity, and GS over time were not statistically significant. Conclusion: Frequent KP alone, obesity alone, and the combination of frequent KP and obesity were all associated with decreased GS in older adults. These associations did not change in any of the groups longitudinally; as such, the slopes corresponding to the data remained unchanged.

Association of Anthropometric and Nutrition Status Indicators with Hand Grip Strength and Gait Speed in Older Adults

“…In longitudinal studies, elevations of several baseline adiposity measures were also associated with a decline of GS . It is known that an excessive load above knee joints usually leads to shorter step length and prompts slower GS …”

“…48 It is known that an excessive load above knee joints usually leads to shorter step length and prompts slower GS. 49 The Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus criteria for identification of undernutrition include functional assessment determined by HGS. 8 However, to our knowledge, the utility of GS for functional status characterization in the context of nutrition assessment has been scarcely investigated.…”

The association of waist circumference with walking difficulty among adults with or at risk of knee osteoarthritis: the Osteoarthritis Initiative

“…Specifically, compared to normal weight adults without knee OA, adults with obese BMI walk more slowly with decreased walking velocities, expend more energy and relative effort when walking 7 , and use more mechanical external work 12 . An overall higher BMI increases loading on the knee 43–45 , which exacerbates pain and gait deficits in those with knee OA 46,47 . Consequently, the lifetime risk of knee OA doubles with high body mass (i.e., an obese BMI) 48 .…”

Effects of weight change and physical activity on knee pain and health-related quality of life in East Asian women aged 50 years and older with knee osteoarthritis: a population-based study

“…A study reported that weight loss and moderate activity were effective in improving function and pain in obese patients with knee osteoarthritis [18,24,[26][27][28]. However, there is little evidence that weight loss is an effective treatment in nonobese patients, especially in the Asian population.…”