title: Physical Function, Hyperuricemia, and Gout in Older Adults.
abstract: OBJECTIVE
  Gout prevalence is high in older adults and those affected are at risk of physical disability, yet it is unclear whether they have worse physical function.
  
  
  METHODS
  We studied gout, hyperuricemia, and physical function in 5,819 older adults (age ≥65 years) attending the 2011-2013 Atherosclerosis Risk in Communities Study visit, a prospective US population-based cohort. Differences in lower extremity function (Short Physical Performance Battery [SPPB] and 4-meter walking speed) and upper extremity function (grip strength) by gout status and by hyperuricemia prevalence were estimated in adjusted ordinal logistic regression (SPPB) and linear regression (walking speed and grip strength) models. Lower scores or times signify worse function. The prevalence of poor physical performance (first quartile) by gout and hyperuricemia was estimated using adjusted modified Poisson regression.
  
  
  RESULTS
  Ten percent of participants reported a history of gout and 21% had hyperuricemia. There was no difference in grip strength by history of gout (P = 0.77). Participants with gout performed worse on the SPPB test; they had 0.77 times (95% confidence interval [95% CI] 0.65, 0.90, P = 0.001) the prevalence odds of a 1-unit increase in SPPB score and were 1.18 times (95% CI 1.07, 1.32, P = 0.002) more likely to have poor SPPB performance. Participants with a history of gout had slower walking speed (mean difference -0.03; 95% CI -0.05, -0.01, P < 0.001) and were 1.19 times (95% CI 1.06, 1.34, P = 0.003) more likely to have poor walking speed. Similarly, SPPB score and walking speed, but not grip strength, were worse in participants with hyperuricemia.
  
  
  CONCLUSIONS
  Older adults with gout and hyperuricemia are more likely to have worse lower extremity, but not upper extremity, function.
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Bridget Teevan
authors.initials: BT
authors.lastname: Burke
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, and University of Freiburg, Freiburg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Köttgen
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Law
authors.affiliation: University of Mississippi Medical Center, Jackson.
authors.forename: Beverly Gwen
authors.initials: BG
authors.lastname: Windham
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Dorry
authors.initials: D
authors.lastname: Segev
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Alan N
authors.initials: AN
authors.lastname: Baer
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Mara A
authors.initials: MA
authors.lastname: McAdams-DeMarco
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test; D005260:Female; D005684:Gait; D006073:Gout / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D033461:Hyperuricemia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D035002:Lower Extremity; D008297:Male; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D034941:Upper Extremity; D016138:Walking