Patients with osteoarthritis foot symptoms at increased risk for death
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Key takeaways:
- Patients with foot symptoms demonstrate a higher risk for all-cause mortality than those without foot symptoms.
- Managing foot symptoms may potentially lower the risk for decreased time to mortality, the researchers wrote.
Among older adults enrolled in an osteoarthritis cohort, those with foot symptoms such as pain and stiffness demonstrated a higher risk for death vs. those without foot symptoms, according to data published in Arthritis Care & Research.
“Foot symptoms may contribute to less physical activity and loss of physical function, which over time could lead to factors that impact mortality, including comorbid conditions from increasing body mass, or falls from muscle weakness, or impaired balance,” Skylar Harmon, BA, a medical student at the University of North Carolina at Chapel Hill, and colleagues wrote.
“One prior study has evaluated the association of foot symptoms with self-reported and performance-based measures of physical function in the [Johnston County Osteoarthritis Project (JoCoOA)] cohort, finding that the presence of foot symptoms was significantly associated with worsened mobility (slower 8-foot walk time) irrespective of knee and hip symptoms and OA,” they added.
To assess whether foot symptoms increase the risk for all-cause mortality, Harmon and colleagues evaluated data from the Johnston County Osteoarthritis Project, a longitudinal, community-based cohort of adults aged 45 years and older, conducted by the Thurston Arthritis Research Center at the University of North Carolina School of Medicine. Patients were recruited into the cohort between 1999 and 2004, with data available on the presence of self-reported foot symptoms. Initial follow-up visits were completed between 2006 and 2010, and second visits were between 2013 and 2015.
The primary study outcome was the time to all-cause mortality, calculated by measuring the time from the first baseline visit until death. The analysis included 2,613 patients, with a total of 813 deaths recorded between 4 and 14.5 years of follow-up.
Of all patients included in the analysis, 37% reported foot symptoms at baseline, according to the researchers. After adjusting for demographic data, comorbidities, activity levels and hip and knee symptoms, the researchers found that “moderate to severe” foot symptoms were associated with a reduced time to death (HR = 1.3; 95% CI, 1.09-1.54). This association remained unchanged after considering walking speed or diabetes, the researchers wrote.
“Foot symptoms, after adjustment for walking speed, sex, race, obesity status or diabetes status, may signify a higher hazard of all-cause mortality in older adults,” Harmon and colleagues wrote. “This is especially an issue for those with at least moderate to severe foot pain, aching or stiffness.”
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Harmon S, et al. Arthritis Car Res. 2023;doi:10.1002/acr.25186.
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