Ability to Sit and Rise From the Floor as a Predictor of All-Cause Mortality

Study Questions:

Is ability to sit and rise from the floor (measure of musculoskeletal strength) associated with mortality?


This was a retrospective study of adults, ages 51-80 years, who were followed from 1997-2011. A sitting-rising test (SRT) was scored from 0-5, with 1 point being subtracted from 5 for each support used (hand/knee), and additional points were taken for unsteady execution and number of attempts. Final SRT score, varying from 0-10, was obtained by adding SRT scores and stratified in four categories for analysis: 0-3; 3.5-5.5, 6-7.5, and 8-10.


A total of 2,002 adults (68% men) were included in this study. The median age of the cohort was 62 years; the overall death rate was 7.9%. Over a median follow-up of 6.3 years, there were 159 deaths. Lower SRT scores were associated with higher mortality (p < 0.001). After adjustment for age, sex, and body mass index, SRT scores were independently associated with mortality in a dose-dependent fashion for a hazard ratio (HR) of 5.44 (95% confidence interval [CI], 3.1-9.5) for a score between 0-3, to 3.44 (95% CI, 2.0-5.9) for a score from 3.5-5.5, and 1.84 (95% CI, 1.1-3.0) for a score between 6 and 7.5, compared to the reference group with the highest scores (8-10). Each unit increase in SRT score conferred a 21% improvement in survival.


The investigators concluded that musculoskeletal fitness, as assessed by SRT, was a significant predictor of mortality among 51- to 80-year-old subjects.


Cardiorespiratory fitness and walking speed have been associated with increased mortality risk. SRT as a functional assessment allows for a deferent examination of musculoskeletal strength and flexibility. An examination of interventions that improve muscle strength and/or flexibility in relation to specific outcomes, including cardiovascular and all-cause mortality, would add to these current findings.

Clinical Topics: Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Prevention, Sports and Exercise Cardiology, Exercise

Keywords: Risk, Follow-Up Studies, Physical Fitness, Exercise, Knee Joint, Cardiovascular System, Geriatric Assessment, Pliability, Body Mass Index, Muscle Strength, Cardiovascular Diseases, Confidence Intervals

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