Original article| Volume 92, ISSUE 12, P2006-2011, December 2011

Stair Negotiation Time in Community-Dwelling Older Adults: Normative Values and Association With Functional Decline

  • Mooyeon Oh-Park
    Correspondence to Mooyeon Oh-Park, MD, Dept of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, 1165 Morris Park Ave, Room 338, Bronx, NY 10461
    Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY

    Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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  • Cuiling Wang
    Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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  • Joe Verghese
    Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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      Oh-Park M, Wang C, Verghese J. Stair negotiation time in community-dwelling older adults: normative values and association with functional decline.


      To establish reference values for stair ascent and descent times in community-dwelling, ambulatory older adults, and to examine their predictive validity for functional decline.


      Longitudinal cohort study. Mean follow-up time was 1.8 years (maximum, 3.2y; total, 857.9 person-years).


      Community sample.


      Adults 70 years and older (N=513; mean age, 80.8±5.1y) without disability or dementia.


      Not applicable.

      Main Outcome Measures

      Time to ascend and descend 3 steps measured at baseline. A 14-point disability scale assessed functional status at baseline and at follow-up interviews every 2 to 3 months. Functional decline was defined as an increase in the disability score by 1 point during the follow-up period.


      The mean±SD stair ascent and descent times for 3 steps were 2.78±1.49 and 2.83±1.61 seconds, respectively. The proportion of self-reported and objective difficulty was higher with longer stair ascent and descent times (P<.001 for trend for both stair ascent and descent). Of the 472 participants with at least 1 follow-up interview, 315 developed functional decline, with a 12-month cumulative incidence of 56.6% (95% confidence interval [CI], 52.1%–61.3%). The stair negotiation time was a significant predictor of functional decline after adjusting for covariates including gait velocity (adjusted hazard ratio [aHR] per 1-s increase: aHR=1.12 [95% CI, 1.04–1.21] for stair ascent time; aHR=1.15 [95% CI, 1.07–1.24] for stair descent time). Stair descent time was a significant predictor of functional decline among relatively high functioning older adults reporting no difficulty in stair negotiation (P=.001).


      The stair ascent and descent times are simple, quick, and valid clinical measures for assessing the risk of functional decline in community-dwelling older adults including high-functioning individuals.

      Key Words

      List of Abbreviations:

      ADLs (activities of daily living), aHR (adjusted hazard ratio), CI (confidence interval)
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