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a School of Health and
Social Sciences, Coventry University, Priory Street, Coventry CV1
5FB, UK, b Epidemiology,
Demography, and Biometry Program, National Institute of Aging,
Bethesda, Maryland, USA, c Department of Health Sciences, University of
Washington, Seattle, USA, d Geriatric
Department, "I Fracticini", National Research Institute (INRCA),
Florence, Italy, e Department
of Medicine and Epidemiology, School of Medicine, Johns Hopkins Medical
Institutions, Baltimore, USA
Correspondence to: Professor Lamb Email: s.lamb{at}coventry.ac.uk
Accepted for publication 29 November 1999
OBJECTIVE
To
investigate the influence of pain severity, knee extensor muscle
weakness, obesity, depression, and activity on the association between
recent knee pain and limitation of usual and fast paced walking, and
ability to rise from a chair.
METHODSA cross
sectional analysis of 769 older women (mean age 77.8, range 65-101)
with physical disability, but no severe cognitive impairment. Severity
of knee pain in the past month was classified as none, moderate, or
severe. Mobility was measured using timed performance tests.
RESULTSThe prevalence
of recent knee pain was 53% (408/769). One third of the women with
pain reported it to be severe. In general, knee pain was only
significantly associated with limited mobility if severe. Obesity,
activity and, to a lesser extent, depression intensified the effects of
pain. Knee extensor weakness did not. Obesity was a distinctive risk
factor in that it substantially increased the risk of mobility
limitation, but only in women with pain. In women who had severe pain,
activity (walking more than three city blocks in the past week)
increased the risk of walking disability more than inactivity.
Depression had a minor, but statistically significant effect on walking
ability, but not the ability to rise from a chair.
CONCLUSIONIn older
women with recent knee pain, a high pain severity score, obesity, and
activity are important factors that increase the risk of mobility limitation.
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