Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Modifiable Predictors of Racial Differences in Gait Velocity in an Elderly Urban Cohort.
Blanco2, Irene, Verghese2, Joe, Lipton2, Richard B., Putterman1, Chaim, Derby2, Carol A.
Gait velocity (GV) is predictive of health status, hospitalizations and mortality and is used to assess functional status the elderly. In the US, elderly Blacks have higher rates of physical disability compared to Whites. Few studies have investigated modifiable risk factors predictive of GV and differences by race. Consequently, we performed a cross-sectional study within a longitudinal, elderly cohort to investigate racial differences in GV and what factors are associated with this measure.
The Einstein Aging Study (EAS) is a longitudinal study of community residing elderly. Participants are recruited using Medicare beneficiary lists and voter registration records. Demographics and medical history are collected as well as the Geriatric Depression Scale, Blessed Information Memory Concentration Test, the SF-36, and the Total Pain Index (TPI) which measures pain severity, location, duration and frequency over 3 months prior to the visit. GV is measured using the GAITrite gait mat embedded with pressure sensors (CIRsystems, Havertown, PA). Nested linear regression models, adjusted for possible confounders, were used to investigate racial differences in GV. To predict decreased GV, we fit linear regression models within each race strata.
157 Whites and 56 Blacks, recruited from 20042009, were included. Whites were older (median 79.9y v 75.5y, p=<0.01), more educated (median 14y v 12y, p<0.01), and had lower BMIs (mean 26.9±4.3 v 28.9±6.4, p=0.03). Blacks had higher proportions of female participants (80.4% v 59.9%, p<0.01), memory loss (7.1% v 1.0%, p=0.02) and diabetes (28.6% v 13.4%, p=0.01). There were no differences between races with regards to depression, osteoarthritis, history of heart attack, COPD, stroke, hip replacement/pinning, hip/femur/pelvis fracture, lower extremity pain or back pain. (All p-values >0.20) Blacks had higher pain levels on the TPI but the difference was not significant (median 3.2 v 2.0, p=0.09). Neither group had higher pain levels on the SF-36.
Blacks had a significantly slower GV (mean 90.19±17.87 v 99.06± 20.08cm/sec, p<0.01). This difference persists despite adjusting for: age, gender, BMI, education, the above listed comorbidities, TPI and pain as measured by SF-36.(b for racial differences: -7.80 cm/sec, p=0.01) In our predictive models, the modifiable risk factors that predicted decreased GV for Whites were: BMI(p<0.001), stroke (p=0.013), hip replacement (0.05), hip/pelvis/femur fractures (p=0.049) and lower extremity pain (p=0.011). For Blacks, lower GV was associated with back pain (p=0.007) and diabetes though not statistically significant (p=0.06)
Differences in GV persist between Blacks and Whites despite adjusting for many confounders like pain, depression, and comorbidities such as diabetes. When analyzed by race, both groups have modifiable risk factors for decreased GV and by extension decreased functional status. Gait velocity of less than 100cm/sec in the elderly has been associated with increased hospitalizations and mortality. Therefore using GV to screen and develop interventions may limit and reduce health disparities in functional decline in the elderly.
To cite this abstract, please use the following information:
Blanco, Irene, Verghese, Joe, Lipton, Richard B., Putterman, Chaim, Derby, Carol A.; Modifiable Predictors of Racial Differences in Gait Velocity in an Elderly Urban Cohort. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2095