Race differences: Identification of community dwelling women at risk for poor health outcomes using walking speed- The osteoarthritis-initiative (OAI) study

Background: Onset of disability, risk of future falls, frailty, functional decline, and mortality are strongly associated with a walking speed(WS) <1.0m/s. The purpose of this study was to determine if those at risk of poor health outcomes(WS <1.0m/s) differed between community-dwelling African-American(AA) and White American (WA) adult women with OA symptoms. Methods: Participants were 2648 women (23% AA) age 45-79 years with baseline WS (Self-selected 20m) in the OAI study. Logistic regression models examined racial differences in WS (<1.0m/s vs. ≥1.0m/s) adjusting for age, gender, education, body mass index (BMI) income, health coverage, work status, OA progression and comorbidities. Results: WS was significantly (p<0.001) slower for AA than WA women (mean WS 1.19 vs 1.33 m/s). Compared to WA, AA women were 4 times (OR=3.6, 95%CI: 2.5- 5.3) more likely to have WS <1.0m/s. Women aged 70-79 years were significantly more likely to have poor health outcomes(p<0.001). Women with higher OA progression (OR: 2.0, CI:1.4-2.9), and obesity(OR: 2.5, CI:1.2- 3.4) were more likely (p<0.001) to have WS <1.0m/s compared to those with incident OA and BMI ≤30kg/m2. Those with cancer, heart failure, and hypertension, were more likely (p<0.001) to have WS <1.0m/s compared to those without these comorbidities. These differences persisted when controlling for health coverage, work status and low income. Conclusions: In this study, race is an independent predictor of poor health (WS <1.0m/s) among community dwelling women. WS may be a useful tool to use in the community setting to identify those at high risk of poor health.