Association Between Walking Speed and Arthritis Risk: Evidence from Five International Aging Cohorts

Background Arthritis is one of the most prevalent chronic musculoskeletal disorders in middle-aged and older adults, leading to impaired physical function and reduced quality of life. Walking speed is a key functional marker of overall health, yet evidence regarding its association with arthritis across diverse populations remains limited. Methods Data were drawn from five large aging cohorts (CHARLS, ELSA, HRS, SHARE, MHAS). Walking speed was measured by standardized gait tests, and arthritis was based on physician diagnosis. Logistic regression, restricted cubic spline models, and subgroup analyses were used to examine associations. Results Across all five cohorts, participants with arthritis had significantly higher walking speeds than those without arthritis. Logistic regression consistently demonstrated a positive association between walking speed and arthritis risk, which remained robust after multivariable adjustment (CHARLS: OR = 1.21, 95% CI: 1.08–1.35; ELSA: OR = 2.15, 95% CI: 1.91–2.43; HRS: OR = 1.28, 95% CI: 1.11–1.48; SHARE: OR = 1.37, 95% CI: 1.19–1.57; MHAS: OR = 1.63, 95% CI: 1.19–2.25; all P < 0.01). Stratified analyses further confirmed that female sex and hypertension were consistent risk factors, while higher educational attainment was protective across several cohorts. Restricted cubic spline analyses revealed significant nonlinear associations in CHARLS, ELSA, HRS, and MHAS, suggesting threshold effects where arthritis risk increased more sharply beyond specific walking speed levels; in SHARE, a non-monotonic pattern was observed, with risk plateauing and slightly declining at higher walking speeds. Subgroup analyses indicated effect modification by sex in CHARLS and SHARE, and by smoking status in MHAS. Conclusion This multi-cohort study provides robust cross-population evidence that walking speed is positively associated with arthritis risk in middle-aged and older adults, with nonlinear and subgroup-specific variations. Walking speed may serve as a simple, functional marker for arthritis risk stratification, and these findings offer novel insights into the complex interplay between physical function and musculoskeletal health in aging populations.