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Study: Symptomatic osteoarthritis remains strongest contributor to walking difficulty
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Symptomatic knee and hip osteoarthritis were the strongest determinants of walking difficulty, according to a recently published cohort study.
Gillian A. Hawker, MD, MSc, from the University of Toronto, and colleagues performed a screening survey of 18,490 participants aged 55 years or older in Ontario between 1996 and 1998. Researchers linked survey results with administrative health data. The primary outcome was difficulty standing or walking in the prior 3 months.
Investigators found 25% of participants had difficulty walking. Researchers found walking difficulty was linked with older age, female gender, BMI and several health conditions, the greatest contributor of which was hip and knee osteoarthritis (OA), which showed the probability for walking difficulty increased with the number of affected joints. The other health conditions were hypertension, diabetes, cardiovascular disease, peripheral vascular disease, stroke, neurological disease, respiratory diseases, malignancy, mental illness and history of hip fracture.
The predicted probability for a 60-year-old, middle-income, average weight woman to have difficulty walking was between 5% and 10% if the woman had no health conditions. The predicted probability rose to 10% and 20% if the woman had diabetes and cardiovascular disease; it increased to 50% if the woman had OA in two hips or knees; it increased to 60% and 70% if the woman had all of these conditions; and it rose to 80% if the woman had all of these conditions combined plus OA in all hips and knees.
“Given the high prevalence of OA and the substantial physical, social and psychological consequences of walking difficulty, we believe our findings have high clinical relevance to primary care physicians and internal medicine specialists beyond rheumatology,” the researchers wrote. “They indicate a need for a more patient-centered, integrated and comprehensive approach to care for the growing numbers living with multiple conditions, many of whom have painful OA.” – by Will A. Offit
Disclosure: Hawker reports he is the Sir John and Lady Eaton professor and chair of medicine at the University of Toronto.
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